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.
Kwan
Patrick
P
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
Yip
Fung Ping
FP
Hui
Andrew C F
AC
Leung
Howan
H
Ng
Ping Wing
PW
Hui
Kwok Fai
KF
Chan
Iris H S
IH
Chan
Michael H M
MH
Lam
Christopher W K
CW
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