{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T16:36:13Z","timestamp":1792859773532,"version":"4.5.0"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:00:00Z","timestamp":1780099200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:00:00Z","timestamp":1780099200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate seizure control in women of reproductive age treated with valproic acid and to compare seizure outcomes between those who continued valproic acid and those who were switched to other anti\u2010seizure medications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data of women with epilepsy were analyzed from prospectively maintained electronic medical records between 2013 and 2022 at a tertiary epilepsy referral center. Women aged 18 to 45\u2009years with generalized or focal epilepsy who were well controlled on valproic acid were included. Clinical characteristics, anti\u2010seizure medication use, seizure control during valproic acid treatment and after switching to other anti\u2010seizure medications, adverse effects, and pregnancy\u2010related complications were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixty\u2010nine women with epilepsy who were seizure\u2010free for at least one year on valproic acid were included. Of these, 28 had juvenile myoclonic epilepsy, 30 had other idiopathic generalized epilepsy subtypes, and 11 had focal epilepsy. Only 26 patients (37.68%) required a valproic acid dose greater than 800 milligrams per day for seizure control. Eighteen patients were switched from valproic acid to other anti\u2010seizure medications, of whom 10 (55.55%) experienced seizure recurrence at 12\u2010month follow\u2010up. Among patients who continued valproic acid, teratogenicity occurred in three patients (5.88%), with a mean daily dose of 1133 milligrams. The requirement for polytherapy was higher in the switch group compared to the valproic acid continuation group (44.44% versus 11.80%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>In women with epilepsy who are well controlled on low\u2010dose valproic acid, switching to alternative anti\u2010seizure medications is associated with a high risk of seizure recurrence and increased need for polytherapy. Decisions regarding withdrawal of valproic acid should be individualized, planned well in advance of pregnancy, and made after detailed discussion with the patient, balancing the risks of losing seizure control against potential teratogenic effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epd2.70293","type":"journal-article","created":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T15:45:26Z","timestamp":1780155926000},"page":"1544-1553","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of valproate discontinuation on seizure control in women of reproductive age"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1978-6142","authenticated-orcid":false,"given":"Sridhar Subramaniyam","family":"Kalyanasundaram","sequence":"first","affiliation":[{"name":"Department of Neurology Sree Chitra Tirunal Institute for Medical Sciences and Technology  Trivandrum Kerala India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8083-4264","authenticated-orcid":false,"given":"Kiren George","family":"Koshy","sequence":"additional","affiliation":[{"name":"Department of Neurology Sree Chitra Tirunal Institute for Medical Sciences and Technology  Trivandrum Kerala India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0972-3307","authenticated-orcid":false,"given":"Ramshekhar N.","family":"Menon","sequence":"additional","affiliation":[{"name":"Department of Neurology Sree Chitra Tirunal Institute for Medical Sciences and Technology  Trivandrum Kerala India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashalatha","family":"Radhakrishnan","sequence":"additional","affiliation":[{"name":"Department of Neurology Sree Chitra Tirunal Institute for Medical Sciences and Technology  Trivandrum Kerala India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,30]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2016.06.015"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12302"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-1-4160-6171-7.00016-9"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-200427030-00004"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(11)70107-7"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000209279"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1535759720945298"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2011.133"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001772"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebr.2023.100624"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2025.103558"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16407"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awae128"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000209222"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.62.8.1304"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39266.473113.BE"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.18338"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2009.02397.x"},{"issue":"10","key":"e_1_2_11_20_1","article-title":"EEG markers of treatment resistance in idiopathic generalized epilepsy: from standard EEG findings to advanced signal analysis","volume":"10","author":"Cerulli Irelli E","year":"2022","journal-title":"Biomedicine"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000209279"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2023.04.009"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/ane.12216"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2019.06.021"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182574f39"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2005.074203"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16505"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2025.110441"},{"key":"e_1_2_11_29_1","first-page":"11","article-title":"Shifting Valproic acid to Levetiracetam in women of childbearing age with epilepsy: a retrospective investigation and review of the literature","volume":"24","author":"Kuo CY","year":"2020","journal-title":"Front Neurol"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13437"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2020.09.008"}],"container-title":["Epileptic Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epd2.70293","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/epd2.70293","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epd2.70293","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T15:44:57Z","timestamp":1792856697000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/epd2.70293"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,30]]},"references-count":30,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/epd2.70293"],"URL":"https:\/\/doi.org\/10.1002\/epd2.70293","archive":["Portico"],"relation":{},"ISSN":["1294-9361","1950-6945"],"issn-type":[{"value":"1294-9361","type":"print"},{"value":"1950-6945","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,30]]},"assertion":[{"value":"2026-04-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}