Evaluate the effects of antiepileptic drugs on reproductive endocrine system in newly diagnosed female epileptic patients receiving either Valproate or Lamotrigine monotherapy: A prospective study
| Autor: | Harpreet Singh Sidhu, Akshay Sadhotra, R Srinivasa |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent media_common.quotation_subject Endocrine System Lamotrigine 03 medical and health sciences Young Adult 0302 clinical medicine Insulin resistance Sex hormone-binding globulin Risk Factors Internal medicine medicine Humans Menstrual cycle Testosterone hirsutism Menstruation Disturbances media_common 030219 obstetrics & reproductive medicine Epilepsy biology business.industry Free androgen index Valproic Acid Ovary medicine.disease Hormones Endocrinology Neurology biology.protein Anticonvulsants Female Neurology (clinical) business Body mass index 030217 neurology & neurosurgery medicine.drug Follow-Up Studies Polycystic Ovary Syndrome |
| Zdroj: | Epilepsy research. 139 |
| ISSN: | 1872-6844 |
| Popis: | Objective To investigate the development of reproductive endocrine changes in Indian women with epilepsy initiating on either Valproate (VPA) or Lamotrigine (LTG) monotherapy. Methods Reproductive hormonal profiles, hirsutism, ovarian morphology by ultrasonography and menstrual cycle data in newly diagnosed women with epilepsy taking VPA (n = 34) or LTG (n = 32) monotherapy were compared. None of the women were receiving hormonal contraception. Patients gave details of seizure type and frequency, medical and drug history. Body weight and fasting insulin, glucose, testosterone, dihyroepiandrosterone sulfate (DHEAS), androstenedione, sex hormone-binding globulin (SHBG), luteinizing hormone (LH), follicle-stimulating hormone (FSH) were measured. Body mass index, free androgen index and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. Longitudinal evaluations were done at 6th month and at 12th month. After 12th month some VPA-treated women were replaced with LTG and further followed-up twice in next six months. Results The mean testosterone level was significant increased in VPA-treated women at 6th month (p = 0.03), then at 12th month (p = 0.01). More women in the valproate group than the lamotrigine group developed hirsutism (p = 0.06), menstrual disturbances (p = 0.02) and PCOS (p = 0.001). Before valproate therapy, 32% of the patients were obese, this percentage rose to 47% after treatment (p = 0.03). A significant positive correlation was existed between obesity (BMI > 25) and the development of menstrual disturbances (p = 0.006), serum testosterone levels (p = 0.02) and PCOS (p = 0.03). Insulin resistance (HOMA-IR > 2.5) was significant correlated with menstrual disturbances (p = 0.03) and serum testosterone levels (p = 0.02). Substitution of VPA with LTG results in significant reduction in mean testosterone levels (p = 0.005) and means body weight at 6th month (p = 0.01). Conclusion Long-term valproate therapy in Indian women with epilepsy was associated with development of menstrual disturbances, alterations in reproductive hormonal function and increased the risk to developed PCOS. |
| Databáze: | OpenAIRE |
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