Metabolic and hormonal disturbances in women with epilepsy on antiepileptic drug monotherapy.
OBJECTIVE
Women with epilepsy (WWE) tend to have hormonal and metabolic abnormalities, raising concerns about an increased risk of cardiovascular disorders. This study was performed to determine whether epilepsy itself and/or antiepileptic drug (AED) medication cause metabolic abnormalities.


METHODS
WWE in premenopausal state aged 18 to 45 years old, currently on AED monotherapy for more than six months, were recruited for this study. The subjects checked their oral temperature each morning, and tested serum levels for lipid profiles, insulin, glucose, and leptin. A HOMA-index was used as a marker for insulin resistance.


RESULTS
Of the 54 total patients, 18 women were diagnosed with primary generalized epilepsy (PGE) and the other 36 were diagnosed with localization-related epilepsy (LRE). Among the subjects, 19 women were on carbamazepine (CBZ), 12 on valproate (VPA), 12 on lamotrigine (LTG), and 11 on topiramate (TPM). Body mass index increased and HDL-cholesterol decreased in patients on VPA monotherapy compared with CBZ, LTG, or TPM (p=0.046 and 0.002). Metabolic syndrome was more frequently associated with VPA-treated patients (41.7%) than CBZ (5.3%), LTG (0%), or TPM group (0%) (p=0.005). There were no differences in hormonal and metabolic indices between PGE and LRE groups.


CONCLUSIONS
WWE on VPA monotherapy are more obese and more frequently suffer from metabolic syndrome. LTG or TPM may be safer when prescribed to the patients with high risk of cardiovascular disease.
Kim
Jee Young
JY
Department of Neurology, School of Medicine, Ewha Womans University, and Ewha Medical Research Institute, Seoul, Korea.
Lee
Hyang Woon
HW
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002220:Carbamazepine / Q000009:adverse effects / Q000627:therapeutic use; D015897:Comorbidity; D004827:Epilepsy / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D000077213:Lamotrigine; D020738:Leptin / Q000097:blood; D008055:Lipids / Q000097:blood; D024821:Metabolic Syndrome / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors; D014227:Triazines / Q000009:adverse effects / Q000627:therapeutic use; D014635:Valproic Acid / Q000009:adverse effects / Q000627:therapeutic use
D000927:Anticonvulsants; D001786:Blood Glucose; D007328:Insulin; D020738:Leptin; D008055:Lipids; D014227:Triazines; D002220:Carbamazepine; D014635:Valproic Acid; D000077213:Lamotrigine