title: Endocrine effects of valproic acid therapy in girls with epilepsy: a prospective study.
abstract: OBJECTIVE
  It is controversial whether the endocrine dysfunction in epilepsy patients is caused by the epilepsy itself, the antiepileptic therapy, or both. We prospectively evaluated the long-term impact of valproic acid monotherapy compared to other anti-epileptic drugs on anthropometric, metabolic, hormonal, and ultrasonographic parameters in girls with epilepsy.
  
  
  METHODS
  Fifty-seven female patients with epilepsy who had started therapy at mean age of 11.5 ± 3.3 years, 42 with valproic acid (mean dose 13.1 ± 7.0 mg/kg/day and 15 with other anti-epileptic agents were followed for a mean of 3.2 years (range 1.0-8.5 years) in our center. Clinical, hormonal and transabdominal pelvic ultrasound data were collected at 3 time points: before and 6-12 months after onset of anti-epileptic drug treatment; and at the last visit while patients were still taking anti-epileptic drugs.
  
  
  RESULTS
  There were no significant between-group differences regarding changes in height, body mass index standard deviation score, levels of glucose and insulin, or lipid and endocrine profile from first to last visits. Mean thyroid-stimulating hormone level increased significantly between first and last visit only in the valproic acid group (p < 0.001), with no significant difference in free T4 level over time or between groups. The rate of clinical polycystic ovary syndrome for the valproic acid group (11%) was comparable to that reported in healthy controls (5-10%).
  
  
  CONCLUSIONS
  Administration of valproic acid had no adverse effect on body weight, metabolic status or endocrine function over an average follow-up of 3.2 years. Valproic acid appears to be safe for use in girls with epilepsy.
authors.affiliation: Epilepsy Service, Department of Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: hagoldberg@clalit.org.il.
authors.forename: Hadassa
authors.initials: H
authors.lastname: Goldberg-Stern
authors.affiliation: Department of Pediatrics, Assaf Harofeh Medical Center, Zriffin, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Yaacobi
authors.affiliation: Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Moshe
authors.initials: M
authors.lastname: Phillip
authors.affiliation: Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Liat
authors.initials: L
authors.lastname: de Vries
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D004703:Endocrine System / Q000187:drug effects*; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D011446:Prospective Studies; D012189:Retrospective Studies; D013972:Thyrotropin / Q000378:metabolism*; D013997:Time Factors; D014463:Ultrasonography; D014635:Valproic Acid / Q000627:therapeutic use*
chemical_list: D000927:Anticonvulsants; D014635:Valproic Acid; D013972:Thyrotropin
keywords: Epilepsy; Girls; Hormonal side effects; Valproic acid