Pituitary responsiveness to gonadotrophin-releasing and thyrotrophin-releasing hormones in children receiving phenobarbitone.

Masala, A.; Meloni, T; Alagna, S.; Rovasio, P. P.; Mele, Giuseppe; Franca, Vannina

doi:10.1136/bmj.281.6249.1175

Cited by 20 publications

(9 citation statements)

References 9 publications

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“…Our data are in agreement with those from earlier studies on basal PRL levels in epileptic children taking PB (Masala et al, 1980) and in epileptic adults taking different AEDs (Matz et al, 1981) and on PRL responsiveness to intravenous thyrotropin releasing hormone in healthy volunteers undergoing short-term PHT or CBZ therapy . Increased basal and stimulated PRL levels in epileptic patients, particularly in men, could be clinically important (Franceschi et al, 1983).…”

Section: Discussionsupporting

confidence: 93%

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Effects of Long‐Term Antiepileptic Therapy on the Hypothalamic‐Pituitary Axis in Man

et al. 1984

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Effects of long-term antiepileptic therapy on the hypothalamic-pituitary axis were evaluated from the basal and stimulated plasma levels of growth hormone (GH) and prolactin (PRL) and from circadian adrenocorticotropic hormone (ACTH)/cortisol rhythms. Data for patients with well-controlled epilepsy of mild-to-moderate severity were compared with those for normal healthy volunteers. Analysis of the effects of each antiepileptic drug (AED) and of combined AEDs revealed minor abnormalities of stimulated GH secretion in all treated patients. In epileptic men, all individual AEDs (except valproate) and AED polytherapy increased both basal and stimulated plasma levels of PRL. In epileptic women, this effect was more variable and less marked, probably because of early depletion of PRL reserves. Each AED and combined AEDs did not significantly change circadian ACTH/cortisol rhythms in epileptic patients. The effects observed seem not to be related to epilepsy per se. Clinical implications, pathways, and neurotransmitters involved and possible mechanisms of the neuroendocrine effects of long-term AED therapy are discussed.

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Section: Discussionsupporting

confidence: 93%

“…Basal GH levels were not affected by any AED. This was also reported by Masala et al (1980) for children taking PB and by Matz et al (1981) for epileptic adults taking different AEDs. On the contrary, Luoma et al (1 980) found increased basal GH levels in epileptic women taking PB or CBZ.…”

Section: Discussionsupporting

confidence: 77%

Effects of Long‐Term Antiepileptic Therapy on the Hypothalamic‐Pituitary Axis in Man

et al. 1984

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“…However, separate analysis of children with IS and those with other seizure types, or consideration of only younger patients still showed a significant interrelationship between responsiveness and serum basic PRL levels. AEDs are also known to have some effect on PRL levels (Masala et al, 1980;Franceschi et al, 1984;Bonucelli et al, 1985;Laxer et al, 1985). In our study, eight patients with IS had no medication before and during treatment; thereafter, the AEDs were probably not responsible for the PRL elevation.…”

Section: Discussionmentioning

confidence: 43%

Factors Influencing Effectiveness of Thyrotropin‐Releasing Hormone Therapy for Severe Epilepsy in Childhood: Significance of Serum Prolactin Levels

et al. 1989

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Various factors possibly influencing responsiveness to thyrotropin-releasing hormone (TRH) therapy were studied in 38 children (20 M, 18 F) with severe epilepsy. Mean age at treatment was 4.7 years (range; 0-18 years). Seizure type was infantile spasms (IS) in 16, generalized tonic seizures in 8, secondarily generalized partial seizures in 4, generalized tonic-clonic seizures in 2, atypical absence in 5, myoclonic seizures in 1, and atonic seizures in 2 cases. All seizure types were classified by ictal EEGs documented by simultaneous EEG-VTR according to the International Classification of seizures, except for two with atonic seizures and one with IS. Factors analyzed were sex, age, etiology, neurologic abnormality, seizure types, seizure frequency, EEGs, duration of TRH therapy, and serum hormone [human growth hormone (HGH), prolactin (PRL), thyroid-stimulating hormone (TSH)] levels before and after TRH therapy. We showed that: (a) serum PRL level was significantly correlated to effectiveness of TRH therapy (the higher the PRL, the greater the response rate); (b) serum basal PRL decreased significantly, especially in good responders; and (c) serum basal PRL was elevated especially in patients with IS, which responded more to TRH therapy. These interesting findings seen in severe epilepsy of childhood deserve further neuroendocrinologic study.

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“…A close examination of the data obtained by Franceschi et al (1984) shows that PRL response to metoclopramide was significantly increased compared with controls in seven male epileptic subjects treated with PB, while the response remained normal in four female subjects. The sample in our previous investigation was too small to discern a distinctive sex pattern in PRL secretion, while the study by Masala et al (1980) included only male PB-treated subjects.…”

Section: Discussionmentioning

confidence: 98%

“…In a group of children undergoing barbiturate prophylaxis for febrile convulsions, Masala et al (1980) reported higher basal PRL levels than in normal subjects and an enhanced stimulatory effect of thyrotropin-releasing hormone. In a preliminary study, we observed occasionally high basal PRL levels in male subjects treated with PB for an epileptic syndrome (Bonuccelli et al, 1981).…”

mentioning

confidence: 95%

Prolactin Secretion in Epileptic Subjects Treated with Phenobarbital: Sex Differences and Circadian Periodicity

et al. 1986

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Circulating basal prolactin (PRL) levels were evaluated in 126 subjects of both sexes with partial or generalized epilepsy, who were treated with phenobarbital (PB) alone or in combination with either phenytoin or benzodiazepines. A significant increase in PRL levels was observed in male, but not in female, patients compared with a sex- and age-matched healthy volunteer group. Circadian PRL secretion, studied in six male epileptic patients on PB monotherapy and in nine normal subjects, showed comparable 24-h PRL mean values and a preserved PRL surge during the night in both groups; however, a statistically significant additional peak was found in male epileptic subjects during the late afternoon. The cosinor analysis of the data, used to evaluate PRL rhythmicity, showed a disruption of the 24-h periodicity in epileptic subjects, while the 12-h periodicity was maintained. These results indicate that central and/or peripheral mechanisms involved in PRL secretion control are more sensitive to PB alone or in combination with other antiepileptic drugs in male than in female subjects. However, the changes of PRL secretion we found were small and unrelated to the different clinical conditions.

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Pituitary responsiveness to gonadotrophin-releasing and thyrotrophin-releasing hormones in children receiving phenobarbitone.

Cited by 20 publications

References 9 publications

Effects of Long‐Term Antiepileptic Therapy on the Hypothalamic‐Pituitary Axis in Man

Effects of Long‐Term Antiepileptic Therapy on the Hypothalamic‐Pituitary Axis in Man

Factors Influencing Effectiveness of Thyrotropin‐Releasing Hormone Therapy for Severe Epilepsy in Childhood: Significance of Serum Prolactin Levels

Prolactin Secretion in Epileptic Subjects Treated with Phenobarbital: Sex Differences and Circadian Periodicity

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