advancedvalproateteratogenicitypregnancyneural tube defectsmood stabilizerlamotrigine
A 26-year-old female with bipolar I disorder has been well stabilized on valproate 1000 mg daily for 3 years. She presents to discuss family planning as she and her partner want to conceive within the next year. Her valproate level is therapeutic and she has had no manic or depressive episodes since starting the medication. Which of the following is the most critical counseling point regarding valproate and pregnancy?