It has been prescribed since 1978 and reports of the ingredient sodium valproate causing birth defects such as spina bifida go back almost as far. FACS is believed to have affected up to 20,000 babies – ten times more than Thalidomide.
FACS is, Dr Turnpenny points out, less dramatic than the missing and distorted limbs caused by Thalidomide, but the neurological effects are far worse. ‘About ten per cent of foetuses exposed to sodium valproate will have a major congenital malformation such as cleft palate. Twelve per cent are likely to be diagnosed with a neuro-developmental disorder.’
‘The problem is that Epilim is a very good drug,’ says consultant neurologist Suzanne O’Sullivan at BMI The London Independent Hospital. ‘These days we avoid putting women of childbearing age on it as a first-choice drug. Not all doctors are aware of the risk.’
No one is suggesting that women stop taking their anti-epileptic drugs. ‘Major convulsive seizures could cause injury to the baby or a miscarriage, but there are other effective drugs available that are known to be safe during pregnancy,’ says consultant neurologist Dr Jim Morrow at the Royal Victoria Hospital, Belfast.