Endurance adaptation — MRCP Part 1 MCQ
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Correct answer: B — Maintain valproate and effective contraception while awaiting epilepsy-specialist review
The best answer is “Maintain valproate and effective contraception while awaiting epilepsy-specialist review”. Men and their partners should use effective contraception throughout valproate treatment and for 3 months after it stops, allowing one sperm cycle without exposure. Men should not donate sperm during that period. A plan to father a child within the next year warrants specialist review to discuss alternatives, but valproate should not be stopped or tapered without clinical advice because loss of seizure control can be dangerous. Conception in 2 months is therefore deferred while treatment is reviewed.
Reference: MHRA Drug Safety Update, valproate use in men: https://www.gov.uk/drug-safety-update/valproate-use-in-men-as-a-precaution-men-and-their-partners-should-use-effective-contraception