Response to letter “transgenerational adverse effects of valproate can’t be by-passed”

Thank you to Martin et al. for bringing to our attention their report on the transgenerational adverse effects of valproate 1 .Their report, a survey of 108 individuals from 90 families who experienced "complications" from valproate exposure in utero is of scientific interest and is critically important in our contemplations of valproate and risk/benefit decisions as part of shared-decision making in considering this agent.Their report, data gathered when individuals were parents themselves as part of the organization Aide aux Parents d'Enfants souffrants du Syndrome de l'AntiConvulsivant (APESAC), a charity created to provide personal assistance and support to families suffering complications due to valproate exposure during pregnancy concluded that 53% of their children (n = 187) had major congenital malformations and/or neurodevelopmental disorders (e.g.cognitive, language problems).The aforementioned report suggests genetic/epigenetic modifications due to valproate may be transgenerational.