JME female – avoid valproate — RACP Paediatrics MCQ

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ModerateNeurologyJME female – avoid valproateRACP Paediatrics

A 15-year-old girl with JME requires lifelong antiepileptic medication. She is sexually active. Sodium valproate is the most effective agent for JME, but why should it be avoided as first-line in this patient?

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Correct answer: A — Lamotrigine

Valproate is the most effective drug for JME but is CONTRAINDICATED in women of childbearing potential due to teratogenicity (neural tube defects, neurodevelopmental impairment in exposed children). Lamotrigine or levetiracetam are safer alternatives for females with JME. This is mandated by the Valproate Pregnancy Prevention Programme.

Reference: Australian Therapeutic Guidelines – 2024; RACP Paediatric Curriculum – Neurology