Dr. Colm Henry:

I can furnish the committee with a written reply. The Senator is quite correct in saying that there has been knowledge about valproate for many years. This knowledge was heightened, as it were, in February 2018 when the European Medicines Agency introduced new restrictions. Following that, we instituted a communications and support programme to increase awareness among women of childbearing age. Through working with OACS Ireland, Epilepsy Ireland, and a support team we established, we identified 40 families who may have been affected by valproate. Through that we developed a diagnostic pathway in Crumlin hospital, again working with the agencies I mentioned and members of OACS Ireland, including a consultant geneticist and paediatrician. Following on from that pathway, some of these patients and their families will require supports. We are committed to providing those supports. The Senator is, however, absolutely correct. There has been knowledge about anticonvulsants in pregnancy for many years. It is also true that the degree of the knowledge and the strength of the evidence has become more powerful over time. Our response has, therefore, become more powerful over time. From her own work, the Senator will know that people have been alerted to the use of anticonvulsants in pregnancy. As part of this work, we are introducing nurse practitioners to work in the area of women in pregnancy who are on anticonvulsants, in recognition of the greater risk presented by these drugs, even beyond valproate.