A WHO-supported study finds global access to antiseizure drugs is rising, but so are concerns about a widely used medicine that can harm unborn babies.
A new study conducted in partnership with the World Health Organization has revealed that although access to antiseizure medications is expanding in low- and middle-income countries, these drugs are not always being prescribed safely.
Led by Dr. Adrienne Chan and Professor Ian Wong of Aston University, the research examined antiseizure medication use in 73 countries from 2012 to 2022. The increase in prescriptions suggests that more patients now have access to vital neurological treatments. However, the findings also highlight a serious concern: the most commonly prescribed drug, valproate, can cause birth defects and developmental problems in babies when taken by pregnant women. Reported conditions include spina bifida, cleft palate, and difficulties with learning, communication, behavior, and memory.
The World Health Organization (WHO) includes valproate on its list of “essential medicines,” but it has also issued warnings against prescribing it to women and girls of childbearing age due to its known risks. WHO has recognized valproate-related fetal disorders as a significant global health issue.
The researchers say that education is urgently required globally to ensure that the risks are known and alternative medicines are prescribed where necessary. In many high-income countries, tighter regulations and pregnancy prevention programs have reduced valproate use. In contrast, in countries where newer antiseizure drugs are less affordable or available, valproate continues to be prescribed more frequently.
Understanding Global Patterns and Risks
The WHO commissioned the study led by Dr. Chan and Professor Wong as part of ongoing efforts to understand and promote the safe and equitable use of essential neurological medicines worldwide.
The study used sales data from the affected countries, but the researchers say the next step is to understand patterns within specific populations and to evaluate how safety measures are being implemented in different regions. This will give a better understanding of whether such drugs are being prescribed to women of childbearing age and the risks to unborn children.
Dr. Chan said: “Our findings show that access to antiseizure medicines is expanding globally, which is good news for patients who previously had little or no treatment options. But the continued widespread use of valproate in some parts of the world is concerning, given its known risks during pregnancy. Greater global alignment on safe prescribing and education is urgently needed to protect future generations.”
Reference: “Antiseizure medications consumption in 73 countries and regions from 2012 to 2022: a longitudinal trend study” by Adrienne Y.L. Chan, Andrew S.C. Yuen, Yingfen Hsia, Wallis C.Y. Lau, J. Helen Cross, Matthew C. Walker, Frank M.C. Besag, Anchor T.F. Hung, Noha Iessa, Neerja Chowdhary, Kenneth K.C. Man and Ian C.K. Wong, 9 October 2025, eClinicalMedicine.
DOI: 10.1016/j.eclinm.2025.103558
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