Endocrine Effects of Valproate versus Carbamazepine in Males with Epilepsy: A Prospective Study

Abstract

Background/Aims: To prospectively evaluate the long-term impact of valproate (VPA) versus carbamazepine (CBZ) on anthropometric, hormonal, and metabolic parameters in young male patients treated for epilepsy. Methods: Of 61 boys with newly diagnosed epilepsy followed up, 24 were excluded from analysis (17 were lost to follow-up and 7 changed therapy within <1 year). Findings were compared by time, treatment (VPA or CBZ), and epilepsy type (generalized or partial) as well as against a matched control group with adequately treated hypothyroidism. Results: Twenty-four boys were treated with VPA and 13 with CBZ. The weight-standard deviation score (SDS) significantly increased during the first 6 months of treatment (p < 0.001), irrespective of the drug type, but decreased between the first and the last visit (p = 0.01). In patients with generalized epilepsy, there was a slight decrease in height- and weight-SDS between the first and the last visit (p = 0.04 and p = 0.01, respectively). The height-SDS at the last visit was comparable to the parental height-SDS. The mean age at puberty onset was 11.2 and 11.4 years in the study and the control group, respectively (p = 0.08). There were no significant differences in the other parameters by treatment or epilepsy type. Conclusions: Long-term therapy with VPA or CBZ has no significant endocrinological or metabolic adverse effect on male children and adolescents with epilepsy.

The effects of valproate and topiramate use on serum insulin, leptin, neuropeptide Y and ghrelin levels in epileptic children

“…In one recent study, Stern et al observed no change in weight, BMI, insulin, glucose, lipid or endocrine profiles in 57 girls with epilepsy receiving VPA therapy for a mean 3.2 years [12]. The same team also reported no endocrine or metabolic effects in boys using topiramate or VPA after approximately 1 year [13].…”

Pharmacogenetic markers of metabolic disorders in the treatment with valproic acid

“…Результаты ранее проведенных клинических исследований [25] показали, что существуют факторы риска, способствующие увеличению МТ во время приема ВК. Среди женщин, принимающих ВК, чаще регистрируются случаи ВК-индуцированного увеличения МТ по сравнению с мужчинами, хотя этот вопрос является дискутабельным [26]. В частности, влияние пола пациента с эпилепсией на степень ПЭП-индуцированного увеличения МТ было изучено F. El-Khatib и соавт.…”