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Author Notes:

Address correspondence to: Kelly M. McVearry, Center for Functional and Molecular Imaging, Department of Neurology - LM-14 Preclinical Science, Georgetown University Medical Center, 3800 Reservoir Road, NW, Washington, DC 20007, fendstudy@georgetown.edu.

The NIH National Institute of Neurological Disorders and Stroke Data Safety Management Board (DSMB) has reviewed and made recommendations for the design, data collection, and analyses of the parent NEAD study; they have also reviewed this substudy and manuscript.

See publication for full list of acknowledgements.

John VanMeter has no conflict of interest.

William D. Gaillard has no conflict of interest.

Kimford J. Meador also serves on the Professional Advisory Board for the Epilepsy Foundation and receives clinical income from EEG procedures and care of neurological patients.


Research Funding:

This study was supported by the NIH National Institute of Neurological Disorders and Stroke (NIH-NINDS 3RO1-NS038455-06s1), Medical College of Georgia (C-07103859), and Georgetown University Department of Neurology.

Kelly M. McVearry has no conflict of interest and has received research support from NIH NINDS 3RO1-NS038455-06s1, NIH NINDS 2RO1-NS038455-06, Kirschstein National Research Service Award 5 T32 HD0759, and the Medical College of Georgia.

Kimford J. Meador has received research support from NIH grants 2RO1-NS38455, R01-NSO31966-11A2, and N01-NS-5-2364, Glaxo SmithKline, EISAI Medical Research, Myriad Pharmaceuticals, Marinus Pharmaceuticals, NeuroPace, SAM Technology, and UCB Pharma.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Behavioral Sciences
  • Clinical Neurology
  • Psychiatry
  • Neurosciences & Neurology
  • Antiepileptic drugs
  • Pharmacovigilance in fetal drug exposure
  • Prenatal exposure and child development
  • Pregnancy and epilepsy
  • Cognitive teratogens
  • Cognitive fluency
  • Fluid intelligence
  • Valproate
  • Carbamazepine
  • Lamotrigine

A prospective study of cognitive fluency and originality in children exposed in utero to carbamazepine, lamotrigine, or valproate monotherapy


Journal Title:

Epilepsy and Behavior


Volume 16, Number 4


, Pages 609-616

Type of Work:

Article | Post-print: After Peer Review


Objective: To investigate the differential effects of fetal exposure to antiepileptic drugs (AEDs) on cognitive fluency and flexibility in a prospective sample of children. Methods: This substudy of the Neurodevelopmental Effects of Antiepileptic Drugs investigation enrolled pregnant women with epilepsy on AED monotherapy (carbamazepine, lamotrigine, and valproate). Blinded to drug exposure, 54 children were tested for ability to generate ideas in terms of quantity (fluency/flexibility) and quality (originality). Forty-two children met inclusion criteria (mean age = 4.2 years, SD = 0.5) for statistical analyses of drug exposure group differences. Results: Fluency was lower in the valproate group (mean = 76.3, SD = 7.53) versus the lamotrigine (mean = 93.76, SD = 13.5, ANOVA P < 0.0015) and carbamazepine (mean = 95.5, SD = 18.1, ANOVA P < 0.003) groups. Originality was lower in the valproate group (mean = 84.2, SD = 3.23) versus the lamotrigine (mean = 103.1, SD = 14.8, ANOVA P < 0.002) and carbamazepine (mean = 99.4, SD = 17.1, ANOVA P < 0.01) groups. These results were not explained by factors other than AED exposure. Conclusion: Children prenatally exposed to valproate demonstrate impaired fluency and originality compared with children exposed to lamotrigine and carbamazepine.

Copyright information:

© 2009 Elsevier Inc. All rights reserved.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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