skip to main content

Epilepsy – Valproate Prescribing — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

HardEpilepsy & Seizure DisordersEpilepsy – Valproate PrescribingSCE Neurology

A 50-year-old man with a first unprovoked seizure is being considered for newly initiated valproate. What current UK safeguard applies?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Valproate should not be started under age 55 unless two specialists independently document that no other effective or tolerated treatment exists

The best answer is “Valproate should not be started under age 55 unless two specialists independently document that no other effective or tolerated treatment exists”. The MHRA initiation restriction applies to new male and female patients under 55; it differs from rules for men already taking treatment and from the pregnancy-prevention programme. “Any clinician may start valproate freely in every adult male” is a credible alternative elsewhere, but it fails the decisive discriminator in this case. “Valproate is absolutely contraindicated in all males” is a credible alternative elsewhere, but it fails the decisive discriminator in this case. “Only women require consideration of reproductive risk” is a credible alternative elsewhere, but it fails the decisive discriminator in this case. “Two-specialist review is required every year for every man already stable on valproate” is a credible alternative elsewhere, but it fails the decisive discriminator in this case.

Reference: MHRA valproate reproductive-risk guidance: https://www.gov.uk/guidance/valproate-reproductive-risks