Document Detail


Hyperandrogenism, ovulatory dysfunction, and polycystic ovary syndrome with valproate versus lamotrigine.
MedLine Citation:
PMID:  18756476     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate development of components of polycystic ovary syndrome (PCOS) and PCOS in women with epilepsy initiating valproate or lamotrigine therapy.
METHODS: Female individuals with epilepsy and regular menstrual cycles were eligible for this prospective study. Participants were randomized to 12 months of valproate (n = 225) or lamotrigine (n = 222) therapy. Serum androgen levels were measured every 3 months. Urinary pregnanediol glucuronide levels were measured weekly for two 3-month periods. The primary end point was development of PCOS components (ie, hyperandrogenism or ovulatory dysfunction). A post hoc analysis was conducted in women more than 2 years after menarche (177 lamotrigine, (HA) 186 valproate) to exclude OD the confounding effect of puberty.
RESULTS: More women in the valproate group than the lamotrigine group developed (OD) in the prospective (54% valproate, 38% lamotrigine; p = 0.010) and the post hoc (HA) analyses (36% valproate, 23% lamotrigine; p = 0.007). More women in the valproate group than the lamotrigine group developed PCOS (9 vs 2%; p = 0.007). Development of HA was more frequent with OD valproate than lamotrigine among those initiating treatment at age younger than 26 years (44% valproate, 23% lamotrigine; p = 0.002) but was similar if treatment was started at age 26 years or older (24% valproate, 22% lamotrigine).
INTERPRETATION: Development of HA occurred more frequently with valproate than lamotrigine, especially if medication was started at age younger than 26 years.
Authors:
Martha J Morrell; Frances J Hayes; Patrick M Sluss; Judith M Adams; Mohit Bhatt; Cigdem Ozkara; Clay R Warnock; Jouko Isojärvi
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of neurology     Volume:  64     ISSN:  1531-8249     ISO Abbreviation:  Ann. Neurol.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-09-03     Completed Date:  2008-09-19     Revised Date:  2013-08-21    
Medline Journal Info:
Nlm Unique ID:  7707449     Medline TA:  Ann Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  200-11     Citation Subset:  IM    
Affiliation:
Stanford University, Stanford and Neuropace, Mountain View, CA 94043, USA. mmorrell@neuropace.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anovulation / chemically induced,  drug therapy
Epilepsy / drug therapy
Female
Humans
Hyperandrogenism / chemically induced,  drug therapy*
Internationality
Ovulation / drug effects*,  physiology
Polycystic Ovary Syndrome / chemically induced,  drug therapy*
Prospective Studies
Triazines / adverse effects,  pharmacology,  therapeutic use*
Valproic Acid / adverse effects,  pharmacology,  therapeutic use*
Chemical
Reg. No./Substance:
0/Triazines; 99-66-1/Valproic Acid; U3H27498KS/lamotrigine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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