Valproate, Hyperandrogenism, and Polycystic Ovaries

Isojärvi, Jouko; Tapanainen, Juha S.

doi:10.1001/archneur.57.7.1064

Cited by 33 publications

(8 citation statements)

References 14 publications

(16 reference statements)

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“…Early reports in an epileptic population by Isojarvi et al found high rates of polycystic ovarian syndrome (PCOS)-like symptoms [132,133]. PCOS, as defined by the 1990 NICHD PCOS Conference, is an endocrine disorder characterized by chronic anovulation and hyperandrogenemia (evidenced either as clinical hyperandrogenism and/or biochemical evidence of elevated testosterone levels) in the absence of other endinocrinopathies such as congenital adrenal hyperplasia, hyperthyroidism, Cushing's syndrome, or hyperprolactinemia [134].…”

Section: Effects On Reproductive Healthmentioning

confidence: 99%

Valproate and Neuroendocrine Changes in Relation to Women Treated for Epilepsy and Bipolar Disorder: A Review

Reynolds¹,

Sisk²,

Rasgon³

2007

CMC

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Valproic acid (2-n-propylpentanoic acid, VPA) is well-established as a mood-stabilizer for bipolar disorder, in addition to its application as a treatment in neurological disorders such as epilepsy, migraine headaches, and chronic neuropathic pain. Its mechanisms of actions in any of the disorders have not yet been fully elucidated but currently include GABA-ergic inhibitory effects, the suppression of NMDA-mediated excitatory neurotransmission, and possibly effects on monoamines and cerebral glucose metabolism. Given the rising use of VPA by women of reproductive age for various conditions it is increasingly important to understand how VPA affects reproductive and metabolic function in women, yet a number of key issues regarding VPA use in women of reproductive age remain unclear. These include the question of whether VPA use is associated with the development of polycystic ovary syndrome (PCOS)-like features (such as elevated androgen concentrations and/or chronic anovulation). The metabolic effects of VPA use, particularly on insulin sensitivity and weight gain, are also important to understand. Lastly, questions of VPA use during pregnancy and lactation require continued attention. This article reviews the current understanding of VPA's mechanisms of action, effects on the reproductive and metabolic system, and teratogenic qualities, highlighting important future areas of study.

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Section: Effects On Reproductive Healthmentioning

confidence: 99%

Valproate and Neuroendocrine Changes in Relation to Women Treated for Epilepsy and Bipolar Disorder: A Review

Reynolds¹,

Sisk²,

Rasgon³

2007

CMC

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“…Loss of body weight after discontinuation of VPA has contributed to the improvement of the symptoms of PCOS which could indicate that obesity may increase the risk of developing PCOS. In case reports on this subject, the replacement of VPA with lamotrigine resulted in a decline in serum testosterone levels with improved ovarian ultrasonographic findings in the following period [13]. It was also shown that the women who had developed obesity with amenorrhea while being treated with VPA, lost weight after replacing the above psychostabilizers (VPA replaced by lamotrigine) with the restabilization of the menstrual cycle [14].…”

Section: Discussionmentioning

confidence: 97%

Valproate, bipolar disorder and polycystic ovarian syndrome

Okanovic¹,

Zivanovic²

2016

Med pregl

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The treatment of the female patients with bipolar disorder presents various challenges for the clinician. Every woman of reproductive age needs to know the risk and benefits of her pharmacologic treatment options. Bipolar disorder should be considered chronic disorder, whose development is largely affected by hormonal changes and reproductive cycle in women. These issues should be researched more thoroughly in order to opt for the most appropriate treatment in women with bipolar disorder.

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“…In women, an additional concern is polycystic ovary syndrome, which may be associated with excessive weight gain and VPA treatment, but may also be seen with other antiepileptic drugs (AEDs), including CBZ. Substitution of LTG for VPA appears to attenuate the biochemical and structural abnormalities (22)(23)(24)(25)(26). VPA, and to a lesser extent, CBZ also are associated with neural tube defects (27).…”

Section: Juvenile Myoclonic Epilepsymentioning

confidence: 99%

Special Needs of the Adolescent with Epilepsy

Nordli¹

2001

Epilepsia

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Adjustment to the inherent changes of adolescence is a challenge for many children, even healthy ones. Epilepsy may make successful adjustment even more difficult by disrupting self-control, adversely affecting the ability to conform to one's peers, and interfering with independence. Epilepsy and its treatment may affect education, employment, use of alcohol and illicit drugs, sexual activity, and pregnancy. These issues, in turn, may affect seizure control. Matching the medicine to the patient is particularly important in teenagers, a group of patients with special needs. Common seizure syndromes presenting in adolescence are briefly reviewed and used to illustrate key issues that may arise in the selection of an antiepileptic medication (AED). Compliance, interaction with other medications including oral contraceptive medications, cosmetic effects, teratogenicity, and impact on behavior are all factors to be considered. Newer medications may have some advantages over older compounds in this regard, and evidence of their utility is reviewed in the specific context of the epilepsy syndromes. In addition to prescribing medication, other important parts of the therapeutic management involve education, counseling, support, and advocacy. To identify issues and to provide appropriate counseling, it is beneficial to devote some of the office visit to an independent interaction with the patient, apart from the parents. One study questionnaire indicated that nurse specialists may be particularly valuable in supporting and meeting the needs of patients in this age group. Some centers have developed elegant methods of helping the patient make the transition from child neurology to adult neurology.

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Valproate, Hyperandrogenism, and Polycystic Ovaries

Cited by 33 publications

References 14 publications

Valproate and Neuroendocrine Changes in Relation to Women Treated for Epilepsy and Bipolar Disorder: A Review

Valproate and Neuroendocrine Changes in Relation to Women Treated for Epilepsy and Bipolar Disorder: A Review

Valproate, bipolar disorder and polycystic ovarian syndrome

Special Needs of the Adolescent with Epilepsy

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