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Weight and Cholesterol Gains Greater with Valproate than with Lamotrigine in Epileptic Women: Presented at AES

By Fran Lowry

WASHINGTON, DC -- December 8, 2005 -- Young epileptic women treated with valproate (VPA) gain more weight and have worse cholesterol levels than women treated with lamotrigine, (LTG), according to the results of an international, multicenter, randomized trial.

Frances J. Hayes, MD, Massachusetts General Hospital, Boston, Massachusetts, United States, presented the study findings here on December 5^th at the 59^th Annual Meeting of the American Epilepsy Society (AES).

"Women with epilepsy are more likely to develop polycystic ovary syndrome, which is associated with excess weight gain, than are women in the general population. The syndrome, which is a reproductive, endocrine disorder, is associated with excess androgen, as well as metabolic and cardiovascular abnormalities," Dr. Hayes explained.

To assess body weight and serum levels during the first year of treatment with either lamotrigine or valproate in adolescent and adult women, Dr. Hayes and colleagues randomized 177 women to open label lamotrigine and 186 women to valproate.

The women, aged 12-40 years, had newly diagnosed and untreated epilepsy or inadequately controlled epilepsy at study entry. Their menstrual cycles were regular and their body mass index was at least 35 kg/m².

"The women were multiethnic, and were recruited from South America, Europe, the US, and India," Dr. Hayes noted.

Fasting levels of total cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol and triglycerides, as well as body weight were measured at baseline and every 3 months during the study. To exclude the confounding effect of puberty on the results the researchers conducted a post-hoc analysis was conducted in women who were more than 2 years post menarche, Dr. Hayes explained.

Results show that treatment with valproate was associated with more weight gain and unfavorable changes in HDL-cholesterol and triglyceride levels during the first year of treatment. However, body weight and serum lipid levels were unaffected by treatment with lamotrigine, Dr. Hayes said.

Mean weight gain was 2.8 kg in the valproate group and 0.2 kg in the lamotrigine group (P < .001). Mean serum triglyceride concentrations increased 8.4 mg/dL in women taking valproate, while these concentrations decreased slightly in the lamotrigine group.

Total cholesterol levels decreased slightly in both treatment groups. However, there was a mean decrease in serum HDL-cholesterol of 2.6 mg/dL in women taking valproate, compared with a slight increase of 0.6 mg/dL in women taking lamotrigine (P = .001).


[Presentation title: Body Weight and Serum Lipid Levels in Young Women with Epilepsy Treated with Valproate Versus Lamotrigine. Abstract 2.346]

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