Endocrine valproate

Isojarvi JI, Laatikainen TJ, Knip M, et al Obesity and endocrine disorders in women taking valproate for epilepsy. Ann Neurol 39 579-584, 1996... 

The use of valproate in young women has been associated with an increased incidence of menstrual abnormalities (1154), polycystic ovaries, and hyperandrogenism (SEDA-18, 69 SEDA-20, 68). Of 22 valproate-treated women who underwent endocrine evaluation, 13 were obese and 11 had marked weight gain (mean 21 kg) after starting valproate (1155). There were polycystic ovaries, hyperandrogenism, or both in 64%, but the clinical relevance of these findings remains uncertain. 

Polycystic ovary syndrome (polycystic ovaries, hjrper-androgenism, obesity, hirsutism, anovulatory cycles, and menstrual disorders) is more common in women with epilepsy. Valproate has been associated with alterations in reproductive hormonal function beginning in the first month of treatment. Serum androgen concentrations increase in patients taking valproate but the profile of hormonal changes is different in women and men (97). Animal studies have corroborated the adverse ovarian and endocrine effects of valproate (98). Four review articles have dealt with this reported adverse event, highlighting controversial views (99-102). 

Endocrine The effects of levetiracetam and valproic acid monotherapy on sex steroid hormone profiles in prepubertal children have been investigated in 30 subjects [325 ]. Ten took levetiracetam, 10 took valproate, and 10 were healthy controls. Those who took valproate had significantly higher androstenedione concentrations than those who took levetiracetam and controls. All other reproductive endocrine hormones were similar among the groups. 

Endocrine The effects of long-term carbamazepine ( = 18) and valproate ( = 14) on thyroid function in newly diagnosed children with epilepsy have been evaluated in a prospective open comparison with 32 sex- and age-matched controls [78. At baseline evaluation, thyroid function was normal. At the 3rd, 6th, and 12th month evaluations, patients taking carbamazepine had serum thyroxine (T4) and free thyroxine (fT4) concentrations significantly lower than baseline and control subjects valproate had no such effect. 

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