And remember that pharma companies have less sway over medical opinion in Europe.
The European Medicine Agency (EMA)'s Pharmacovigilance and Risk Assessment Committee has recommended strengthening the restrictions on the use of valproate in women of childbearing age.
This is because of the risk for malformations and developmental problems in children exposed to valproate during pregnancy.
The committee recommends that valproate not be used to treat epilepsy or bipolar disorder in girls and women who are pregnant or who can become pregnant unless other treatments are ineffective or not tolerated.
It adds that women for whom valproate is the only option should use effective contraception and that a doctor experienced in treating these conditions should start and supervise treatment.
The advice also applies to the use of valproate for the prevention of migraine.