April 15, 2009

NYT: "I.Q. Harmed by Epilepsy Drug in Utero"

The New York Times reports on an apparent nasty side effect of an epilepsy drug, with this lead-in from the NYTimes.com home page: "Lower I.Q. in Children Linked to Mother’s Use of Epilepsy Drug:"

Three-year-olds whose mothers had taken valproate during pregnancy had I.Q. scores that were nine points lower on average than children whose mothers had taken a different antiseizure medication, lamotrigine. The I.Q. scores of toddlers whose mothers took valproate were also lower than scores of children whose mothers took two other antiseizure medications, phenytoin and carbamazepine. ...

Cognitive assessments were conducted in 258 2- and 3-year-olds born to 252 mothers, of whom 53 had taken valproate.

Over all, children’s I.Q. scores were strongly related to mothers’ I.Q. scores, except among the children of mothers treated with valproate [generic name Depakote], the study found.

At age 3, children exposed to valproate in utero had a mean I.Q. of 92, compared to 101 for children exposed to lamotrigine, 99 for those exposed to phenytoin, and 98 for those exposed to carbamazepine, the study found.

Have you ever noticed how in the New York Times' universe, IQ is unquestionably valid and terribly, terribly important in the Health section of the newspaper? (See, for example, the NYT's recurrent coverage of the effects of the exposure to lead in reducing I.Q.)

In this Health section article, for example, the Times is getting worked up over an IQ test given to 2-3 year olds, which is pushing the age limits of IQ testing. And the sample size is only 53. And yet, there's absolutely zero quibbling about the usefulness of IQ testing in this article. It's simply assumed that, of course, everybody knows that a difference in average IQ scores of about eight points is a big deal.

Yet, in the Education section of the Times, where you might think IQ would be even more relevant, it rarely comes up. And when it does put in an unwelcome appearance, it is often dismissed as discredited.

And here's the headline in the Washington Post, "Epilepsy Drug in Pregnancy May Lower Child's IQ," which links to the AP's article by Mike Stobbe. It too simply assumes that IQ is a valid and important thing.

16 comments:

  1. "Have you ever noticed how in the New York Times' universe, IQ is not only unquestionably valid, but terribly, terribly important in the Health section of the newspaper."

    The only problem the NYT has with IQ is that the wrong race has too much of it: whitey.

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  2. Three-year-olds whose mothers had taken valproate during pregnancy had I.Q. scores that were nine points lower on average...So this, like heading in soccer, lowers the IQ environmentally but doesn't touch the underlying genetic IQ factor(s). And these kids, being effectively dumber, would grow up to have larger families than the unaffected cohort.

    So in the long run, valproate is eugenic.

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  3. Don't miss the editorial by Kristof where it is implied that IQ is infinitely expandable.

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  4. just as other papers assert that race is an unscientific concept while their medical pages report on the appropriate treatment for people of different racial backgrounds

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  5. The teratogenicity of valproic acid is not even news. The drug has long been known to cause neural tube defects and should be avoided during pregnancy.

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  6. No one ever doubted whether environmental interventions could lower IQ (e.g., malnutrition, formula feeding instead of milk, "stereotype threat", apparently this epilepsy drug). It's much less clear what normal parents can do to raise their child's IQ.

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  7. Brand Name: Depakote. Generic Name: Divalproex

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  8. Are there any nutrients that can increase IQ during fetal development?

    Vitamin D? Fish Oil? Anything?

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  9. Lucius Vorenus4/16/09, 9:02 AM

    tommy: The teratogenicity of valproic acid is not even news. The drug has long been known to cause neural tube defects and should be avoided during pregnancy.

    I didn't RTF, but just from the excerpts which Steve posted, I kept wondering whether there was a control here: It sounded from the excerpt as though the Valproate babies had IQs which were 8 points lower than the non-Valproate babies' IQs, not that the Valproate babies had IQs which were 8 points lower than their own mothers' & fathers' IQs.

    If it's true that it was known [or should have been known] that there was a problem with Valproate & birth defects, then one very obvious explanation here is that all they've done is create a filter which outputs only the stupid mothers who were seeing the stupid GPs & the stupid OB/GYNs.

    PS: Okay, I broke down and RTF'ed, and all I could find was this throwaway line:

    Over all, children’s I.Q. scores were strongly related to mothers’ I.Q. scores, except among the children of mothers treated with valproate, the study found.

    It seems to me that there are at least three crucial pieces of information here:

    BFIQ = [Biological] Father's IQ
    MIQ = Mother's IQ
    CIQ = Child's IQ

    Other than that one throwaway line, the article doesn't give any indication as to how CIQ varies from MIQ & BFIQ as the anti-seizure medication is varied.

    And the fact that the word "father" doesn't even appear in the article would tend to lead one to wonder whether the mothers even knew who the baby daddies were, which, in turn, would make one wonder whether the mothers were in fact...

    PPS: For practical purposes, I should think that for expectant couples, an even more important set of figures would be these:

    GPIQ = General Practioner's IQ
    OBGYNIQ = OB/GYN's IQ

    If Valproate is known to cause birth defects, and if there are still GPs and OB/GYNs prescribing it, then we've got serious problems with the medical industry in this country.

    Which brings to mind the famous joke -

    Q: What do you call the fellow who finished last in his medical school class?

    A: Doctor.

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  10. Chief Seattle4/16/09, 9:05 AM

    It was the same way with the article a few weeks ago on older men having offspring with lower IQ. If it's used as a hammer against older men dating younger women, a few points are enough for the Times. If it's related to race, well then even 15 points can be explained away by mysterious "environmental" factors.

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  11. Lucius Vorenus4/16/09, 12:49 PM

    RTF = RTFA

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  12. Are there any nutrients that can increase IQ during fetal development?

    Vitamin D? Fish Oil? Anything?
    I remember a study which suggested that mothers who consumed a certain kind of fish in Hong Kong had babies with higher IQs. The difference was only 2-3 IQ points and I doubt they controlled for parental IQ. That is precisely the problem--until we control for the IQ of the parents, we aren't likely to identify those substances which may positively impact intelligence during fetal development. This is especially true when many of these foods, nutrients, or drugs are likely to be consumed by people with higher IQs in the first place.

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  13. Other than that one throwaway line, the article doesn't give any indication as to how CIQ varies from MIQ & BFIQ as the anti-seizure medication is varied.That is true, but in the case of epilepsy I wouldn't suspect there would be radical differences in IQ. Epileptics are likely to use the medications that work best for them with the fewest side effects if the difference in cost isn't overwhelming. These drugs aren't necessarily cheap, but they aren't chemotherapeutic agents, either.

    Of course, that a mother would continue to take valproic acid during pregnancy might say something about the mother's IQ.

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  14. Lucius Vorenus:

    That is almost exactly like the joke we told in the (enlisted ranks of the) USMC.

    "What do you call the guy who finished last in his OCS class?"

    "Sir."

    In our unit (cryptologic linguists) there may have been a certain bitter undertone to that joke.

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  15. An interesting experiment...

    Lets say you could offer a headache pill or other commonly consumed drug that had only a single side effect, when taken by pregnant mothers, the IQ of the child would be 10 points lower. Everything else unaffected, child just as healthy, tall etc etc

    We would soon start to find out who really thought there was no such thing as IQ.

    Equally a similar drug test; only one side effect - raise child's IQ by 10 points.

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  16. That is almost exactly like the joke we told in the (enlisted ranks of the) USMC.

    "What do you call the guy who finished last in his OCS class?"

    "Sir."

    ***************************
    Similar vein, with all the Dr. Mengele med visits I had as a GI.


    Q: What do you call the guy who finished last in his med school class?
    A: Captain, US Army Medical Corps

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