title: Endocrine effects of valproate in adolescent girls with epilepsy.
abstract: OBJECTIVE
  To investigate the effect of epilepsy and/or valproate (VPA) monotherapy on physical growth, weight gain, pubertal development, and hormonal status in adolescent girls with epilepsy.
  
  
  METHODS
  The study group included 88 consecutive female patients with epilepsy aged 6-20 years (28 premenarche, 60 postmenarche) attending an endocrinology institute of a major tertiary center. Forty-five patients were under treatment with VPA, and 43 were before treatment initiation. The groups were compared for the relevant biochemical, anthropometric, ultrasonographic, and endocrine parameters.
  
  
  RESULTS
  No statistically significant differences were found in any of the parameters studied between the groups, as a whole or by menarche status. The treated postmenarcheal subgroup had a higher mean testosterone level than the untreated postmenarcheal controls (1.83 +/- 0.65 vs. 0.88 +/- 0.24, p=0.006). Body mass index--standard deviation score (BMI-SDS) was 0.75 in the treated group and 0.63 in the untreated group; rates of obesity were 16.3% and 15.5%, respectively. No between-group differences were found in menses irregularities, hirsutism, or acne. No correlation was found between duration or dosage of treatment and BMI-SDS, height-SDS, or androgen level. The treated group had higher levels of thyroid-stimulating hormone and lower levels of free thyroxine than did the untreated group, although still within normal range.
  
  
  CONCLUSIONS
  Long-term treatment with VPA in girls with epilepsy is associated with increased testosterone levels after menarche, without clinical hyperandrogenism, polycystic ovary syndrome, or an increase in BMI-SDS. VPA is a good treatment option in this age group but should be accompanied by careful endocrine observation.
authors.affiliation: Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Petah Tiqwa, Israel.
authors.forename: Liat
authors.initials: L
authors.lastname: de Vries
authors.forename: Anna
authors.initials: A
authors.lastname: Karasik
authors.forename: Zohar
authors.initials: Z
authors.lastname: Landau
authors.forename: Moshe
authors.initials: M
authors.lastname: Phillip
authors.forename: Sara
authors.initials: S
authors.lastname: Kiviti
authors.forename: Hadassa
authors.initials: H
authors.lastname: Goldberg-Stern
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000494:pharmacology* / Q000627:therapeutic use*; D001827:Body Height / Q000187:drug effects; D015992:Body Mass Index; D002648:Child; D015897:Comorbidity; D004827:Epilepsy / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008572:Menarche / Q000187:drug effects; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology; D011085:Polycystic Ovary Syndrome / Q000175:diagnosis / Q000453:epidemiology; D013739:Testosterone / Q000097:blood*; D013972:Thyrotropin / Q000097:blood*; D013974:Thyroxine / Q000097:blood*; D014635:Valproic Acid / Q000494:pharmacology* / Q000627:therapeutic use*
chemical_list: D000927:Anticonvulsants; D013739:Testosterone; D014635:Valproic Acid; D013972:Thyrotropin; D013974:Thyroxine