Longitudinal follow-up of reproductive and metabolic features of valproate-associated polycystic ovarian syndrome features: A preliminary report.
BACKGROUND
In the Systematic Treatment Enhancement Program for Bipolar Disorder, we showed that valproate is associated with new-onset menstrual-cycle irregularities and hyperandrogenism in 10.5% of 86 women. We now determine whether polycystic ovarian syndrome (PCOS) features reverse on valproate discontinutation.


METHODS
Women with valproate-associated PCOS and those at risk for PCOS (valproate use < or =6 months) were re-evaluated for PCOS.


RESULTS
Follow-up (mean 17 months) assessments were completed in 14 women (5 with treatment-emergent PCOS, 9 on valproate < or =6-month). Of seven women who developed valproate-associated PCOS, PCOS reproductive features remitted in three of four discontinuing valproate and persisted in all 3 continuing valproate. Menstrual-cycle irregularities improved among valproate-discontinuers whose PCOS features remitted (p = 0.01). There was a trend toward lower serum testosterone (p = 0.06). Body-weight and polycystic ovarian morphology did not change.


CONCLUSIONS
In the first longitudinal bipolar-disorder study of valproate-associated PCOS, most valproate-discontinuers had improved reproductive features of PCOS despite static body-weight.
Joffe
Hadine
H
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA. hjoffe@partners.org
Cohen
Lee S
LS
Suppes
Trisha
T
Hwang
Cindy H
CH
Molay
Francine
F
Adams
Judith M
JM
Sachs
Gary S
GS
Hall
Janet E
JE
D000293:Adolescent; D000328:Adult; D018692:Antimanic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000150:complications / Q000188:drug therapy; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006628:Hirsutism / Q000139:chemically induced; D006801:Humans; D017588:Hyperandrogenism / Q000139:chemically induced; D008137:Longitudinal Studies; D008660:Metabolism / Q000187:drug effects*; D008875:Middle Aged; D050177:Overweight; D011085:Polycystic Ovary Syndrome / Q000139:chemically induced* / Q000150:complications* / Q000378:metabolism; D012098:Reproduction / Q000187:drug effects*; D013739:Testosterone / Q000097:blood; D014635:Valproic Acid / Q000009:adverse effects* / Q000627:therapeutic use
D018692:Antimanic Agents; D013739:Testosterone; D014635:Valproic Acid