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Valproic acid: probable endocrine disruptor

Some of the adverse effects of valproic acid are linked to disruption of the human body's hormone systems. Children, especially those exposed in utero, and adolescents are particularly sensitive to effects of this type.

Endocrine disruptors are substances that disturb hormonal function in living organisms or their progeny. There is growing interest in chemicals that are present in the environment and exert their toxic effects by disrupting hormone systems. Endocrine disruptors have been implicated in various conditions, including reproductive disorders, type 2 diabetes, obesity, behavioural disorders and some cancers.

Many drugs interfere with various hormone systems of the human body. In some cases, the drug’s hormonal effects are unwanted. This is the case for amiodarone, lithium, glucocorticoids, some antiarrhythmics, some opioids and neuroleptics.

It is also the case for valproic acid, a drug that has been in use since the 1960s in epilepsy, then in various neuropsychiatric disorders.

Fertility disorders and erectile dysfunction have been observed in affected men. Menstrual disorders and polycystic ovary syndrome have been observed in women.

Birth defects, fetal and neonatal disorders, and disorders of neuropsychological development (reduced IQ, language delay, etc.) observed in the long term in children exposed in utero are possibly a consequence of valproic acid’s endocrine disrupting effects on the fetus.

©Prescrire 1 April 2021

Source: "Valproic acid: is it an endocrine disruptor?" Prescrire International 2021; 30 (225): 96-100. Subscribers only.

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For more information:

"Antiepileptics and pregnancy:
potential long-term effects in children "
(January 2020)

"Avoid pregnancy during
treatment with valproic acid
or its derivatives"
(December 2018)

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