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Clinical Signs Of Hyperandrogenism With Valproate More Common In Epilepsy Patients Than Bipolar Patients
A DGReview of :"Valproate-associated reproductive and metabolic abnormalities: are epileptic women at greater risk than bipolar women?"
Progress in Neuro-Psychopharmacology & Biological Psychiatry
02/10/2003
By Alison Palkhivala
Valproate therapy may cause menstrual abnormalities and increased total serum testosterone levels in women with epilepsy or bipolar disorder.
Women with bipolar disorder taking the drug were, however, found to be less likely than those with epilepsy to have clinical features of hyperandrogenism.
Thirty women, aged 18 to 40, with a diagnosis of bipolar disorder based on Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria, and 15 women with idiopathic generalized epilepsy were evaluated for reproductive and endocrine functioning and metabolic parameters. Among the women with bipolar disorder, 15 were on lithium monotherapy and 15 were on valproate monotherapy or valproate combined with lithium therapy. All the women with epilepsy were on valproate monotherapy. The study was conducted by F. Akdeniz and colleagues from the department of psychiatry, Affective Disorders Unit, Ege University School of Medicine, Izmir, Turkey.
The two groups of women were similar with respect to menarche age, mean length of menstrual cycle and mean length of menses. However, three of the bipolar patients taking valproate and seven of the epileptic patients taking this drug reported menstrual difficulties. None of the patients with bipolar disorder taking lithium monotherapy reported such problems.
Epilepsy patients had higher hirsutism scores than did bipolar patients, regardless of the therapy they were taking. Serum total testosterone levels were higher among those taking valproate, compared with lithium, regardless of the condition it was being taken to treat. Serum follicle stimulating hormone (FSH) levels were significantly lower and luteinizing hormone (LH)-to-FSH ratios were significantly higher in patients with epilepsy than those with bipolar disorder, regardless of the treatment they were receiving. Weight parameters and lipid values were similar between the two groups of women.
Prog Neuropsychopharmacol Biol Psychiatry 2003 Feb;27:1:115-21.
"Valproate-associated reproductive and metabolic abnormalities: are epileptic women at greater risk than bipolar women?"
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