Valproate chez les hommes : trois mois de contraception sont recommandés

Zitouni Imounachen 14/02/2024 351

Une étude suggère un risque accru de troubles neurologiques et du développement chez des enfants dont le père a été traité par valproate dans les trois mois avant la conception, en comparaison à un traitement par lamotrigine ou lévétiracétam.

Selon la situation du patient, une contraception peut être mise en place pendant le traitement ; elle doit être maintenue au moins trois mois après l’arrêt de celui-ci. En complément de l’alerte émise en août 2023 sur le risque potentiel de troubles neurologiques et du développement chez les enfants dont les pères ont été traités par valproate ou ses dérivés dans les 3 mois précédant la conception, l’Agence nationale de sécurité du médicament et des pro- duits de santé (ANSM) précise la durée de contraception à recommander :
– après discussion avec le médecin, mise en place de mesures contraceptives efficaces pendant le traitement et au moins 3 mois après l’arrêt de celui-ci,
– pas de don de sperme pendant le traitement et au moins 3 mois après l’arrêt de celui-ci. Il est recommandé aux hommes qui désirent avoir un enfant de parler de ce projet avec leur médecin afin d’évoquer le risque potentiel et les alternatives envisageables, sans perte de chance sur l’évolution de la maladie.

Le traitement par valproate ou un de ses dérivés ne doit pas être arrêté sans avis du médecin. Rappelons que le valproate (et dérivés) est un agent tératogène connu en cas d’exposition du fœtus au cours de la grossesse. Il augmente le risque de malformations congénitales (11 %) et de troubles neurodéveloppementaux collaboration précieuse que nous jetons les bases d’un avenir où le vieillissement sera synonyme de vitalité, de bien-être et de qualité de vie.

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