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Hormone profiles in young adults with epilepsy treated with sodium valproate or lamotrigine monotherapy.
- Source :
-
Epilepsia [Epilepsia] 2001 Aug; Vol. 42 (8), pp. 1002-6. - Publication Year :
- 2001
-
Abstract
- Purpose: Treatment with sodium valproate (VPA) may be associated with polycystic ovarian syndrome (PCOS) in some women with epilepsy. By comparing hormone profiles in young adults taking VPA or lamotrigine (LTG) as monotherapy, this study aimed to explore whether a pharmacologic effect of VPA could be responsible for this observation.<br />Methods: Hormone profiles in men and women taking VPA (n = 40) or LTG (n = 36) monotherapy for epilepsy were compared. None of the women were receiving hormonal contraception or replacement. Patients gave details of seizure type and frequency, menstrual cycle, and medical and drug history. Body mass index was calculated, and fasting insulin, glucose, cholesterol, triglycerides (TG), high- and low-density lipoproteins, testosterone, dihydroepiandosterone (DHEA), androstenedione, sex hormone-binding globulin (SHBG), free androgen index (FAI), luteinising hormone (LH), follicle-stimulating hormone (FSH), and antiepileptic drug (AED) concentrations were measured.<br />Results: There were no differences between treatment groups for both sexes in age and seizure control. Only four obese VPA-treated women were hyperinsulinaemic (p = 0.05); three with abnormal menstrual cycles; one with raised testosterone. Testosterone (p = 0.02), FAI (p = 0.03), and TG (p = 0.02) levels were higher, however, in women taking the drug. Obese patients of both sexes (p = 0.01) and VPA-treated men (p = 0.03) had higher insulin concentrations.<br />Conclusions: VPA therapy may be associated with subclinical elevation in fasting insulin levels. Testosterone and TG levels were higher in VPA-treated women compared with the levels in those taking LTG. However, only a minority of obese females exhibited biochemical characteristics suggestive of PCOS. Biochemical screening may allow women at risk of developing PCOS to avoid VPA.
- Subjects :
- Adult
Blood Glucose analysis
Body Mass Index
Comorbidity
Dehydroepiandrosterone blood
Epilepsy epidemiology
Female
Humans
Hyperinsulinism blood
Hyperinsulinism epidemiology
Lamotrigine
Lipids blood
Male
Menstruation Disturbances blood
Menstruation Disturbances epidemiology
Obesity blood
Obesity epidemiology
Polycystic Ovary Syndrome blood
Polycystic Ovary Syndrome epidemiology
Sex Factors
Triazines adverse effects
Triglycerides blood
Valproic Acid adverse effects
Anticonvulsants standards
Anticonvulsants therapeutic use
Epilepsy blood
Epilepsy drug therapy
Insulin blood
Polycystic Ovary Syndrome chemically induced
Testosterone blood
Triazines therapeutic use
Valproic Acid therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 0013-9580
- Volume :
- 42
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Epilepsia
- Publication Type :
- Academic Journal
- Accession number :
- 11554885
- Full Text :
- https://doi.org/10.1046/j.1528-1157.2001.0420081002.x