Show simple item record

dc.contributor.authorWatkins, L
dc.contributor.authorCock, H
dc.contributor.authorAngus-Leppan, H
dc.contributor.authorMorley, K
dc.contributor.authorWilcock, M
dc.contributor.authorShankar, R
dc.date.accessioned2020-04-16T07:04:04Z
dc.date.issued2019-02-20
dc.description.abstractRecent publication of the Medicines and Healthcare products Regulatory Agency (MHRA) in the United Kingdom has strengthened the regulatory measures for valproate medicines. It highlights the importance of making women of childbearing age with epilepsy aware of the teratogenic risks of valproate and encourages the withdrawal of it from those currently prescribed. While a significant directive, it raises concerns of not having considered the impact on special populations such as women with Intellectual Disability (ID). While it is important that women with ID are not excluded from such safety initiatives, due caution needs to be taken on a case by case basis preferably, to ensure their best interests are central to the decision making. Many women with moderate to profound ID cannot have informed consented sexual relationships not to mention cognitive incapability to make informed choices on medication suitability. These women are at potential risk of having their epilepsy control undermined due to the MHRA directives. Around 30% of people with moderate to profound ID have seizures of which 60% are considered treatment resistant. In this vulnerable population changes to medication without clear clinical and social insights could lead to increased harm levels. This paper enumerates the challenges of application of the new directive to these special populations and proposes a pathway based on individual cognitive ability to provide informed consent to facilitate the continuation or removal of valproate. It is important not to lose sight of individual circumstances and the importance of working collaboratively toward providing person center care.en_GB
dc.identifier.citationVol. 10, article 139en_GB
dc.identifier.doi10.3389/fneur.2019.00139
dc.identifier.urihttp://hdl.handle.net/10871/120650
dc.language.isoenen_GB
dc.publisherFrontiers Mediaen_GB
dc.rights© 2019 Watkins, Cock, Angus-Leppan, Morley, Wilcock and Shankar. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.en_GB
dc.subjectvalproateen_GB
dc.subjectpregnancyen_GB
dc.subjectcommunicationen_GB
dc.subjectrisk assessmenten_GB
dc.subjectintellectual disabilityen_GB
dc.titleValproate MHRA guidance: Limitations and opportunitiesen_GB
dc.typeArticleen_GB
dc.date.available2020-04-16T07:04:04Z
dc.descriptionThis is the final version. Available from Frontiers Media via the DOI in this record.en_GB
dc.identifier.journalFrontiers in Neurologyen_GB
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_GB
dcterms.dateAccepted2019-02-04
rioxxterms.versionVoRen_GB
rioxxterms.licenseref.startdate2019-02-04
rioxxterms.typeJournal Article/Reviewen_GB
refterms.dateFCD2020-04-16T06:58:30Z
refterms.versionFCDVoR
refterms.dateFOA2020-04-16T07:04:07Z
refterms.panelAen_GB
refterms.depositExceptionpublishedGoldOA


Files in this item

This item appears in the following Collection(s)

Show simple item record

© 2019 Watkins, Cock, Angus-Leppan, Morley, Wilcock and Shankar. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Except where otherwise noted, this item's licence is described as © 2019 Watkins, Cock, Angus-Leppan, Morley, Wilcock and Shankar. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.