Effects of valproate or lamotrigine monotherapy on the reproductive endocrine and insulin-related metabolic profile in Chinese adults with epilepsy: a prospective randomized study.
Cross-sectional studies have suggested that valproate treatment may be associated with hyperinsulinemia and hyperandrogenism in women. Few prospective data are available. We evaluated the reproductive endocrine and insulin-related metabolic parameters in men and women with untreated epilepsy randomized to valproate (n=44) or lamotrigine (n=37) monotherapy for 12 months. On treatment, there was no significant difference in fasting serum insulin concentrations between the two groups. In women (n=40), there was no significant difference between the two groups in change from baseline in serum total testosterone, dehydroepiandrosterone sulfate, luteinizing hormone, or follicle-stimulating hormone. In men (n=41), follicle-stimulating hormone concentration significantly decreased in patients taking valproate compared with those on lamotrigine as early as 3 months after treatment. Greater attention should be paid to investigate the potential impact of valproate on reproductive function in men.
Department of Medicine and Therapeutics, Division of Neurology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China. patrickkwan@cuhk.edu.hk
Patrick
P
Kwan
Fung Ping
FP
Yip
Andrew C F
AC
Hui
Howan
H
Leung
Ping Wing
PW
Ng
Kwok Fai
KF
Hui
Iris H S
IH
Chan
Michael H M
MH
Chan
Christopher W K
CW
Lam
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D004703:Endocrine System / Q000187:drug effects / Q000378:metabolism; D004827:Epilepsy / Q000097:blood / Q000188:drug therapy*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006728:Hormones / Q000097:blood*; D006801:Humans; D007328:Insulin / Q000097:blood*; D000077213:Lamotrigine; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D055442:Metabolome / Q000187:drug effects; D008875:Middle Aged; D011446:Prospective Studies; D013739:Testosterone / Q000097:blood; D013997:Time Factors; D014227:Triazines / Q000627:therapeutic use*; D014635:Valproic Acid / Q000627:therapeutic use*; D055815:Young Adult
D000927:Anticonvulsants; D006728:Hormones; D007328:Insulin; D014227:Triazines; D013739:Testosterone; D014635:Valproic Acid; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D000077213:Lamotrigine