Ovulatory Failure Is Most Common in Women with Primary Generalized Epilepsy Treated with Valproate.
Abstract number :
J.01
Submission category :
Year :
2001
Submission ID :
3101
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
M.J. Morrell, M.D., Neurology, Columbia University, New York, NY; K.L. Flynn, M.A., Neurology, Columbia University, New York, NY; S. Done, B.S., Neurology, Columbia University, New York, NY; E.R. Flaster, M.S., Columbia University, New York, NY; M.V. Saue
RATIONALE: Anovulatory cycles may be more frequent in women with epilepsy (WWE). The frequency of ovulatory cycles has not been determined in a large cohort, nor has the contribution of epilepsy syndrome and antiepileptic drugs (AEDs)been delineated.
METHODS: We evaluated 84 WWE (52 LRE, 32 PGE) between the ages of 18-40 and 22 age-matched non-epileptic controls. WWE received either phenytoin, carbamazepine, phenobarbital, gabapentin, lamotrigine or valproate monotherapy for at least 6 months prior to study entry. Subjects recorded basal body temperatures and urinary LH and a mid-luteal progesterone measurement was obtained over 3 cycles to determine ovulatory function. Seizure, AED and reproductive history inventories were also collected.
RESULTS: We observed an interaction effect between epilepsy syndrome and the use of valproate within the last 3 years on ovulatory function, adjusting for BMI and age. Eleven percent of cycles were anovulatory in controls. Women with LRE using valproate within 3 years (n=9), women with LRE not being treated with valproate (n=43), and women with PGE not being treated with valproate (n=14), had 15% anovulatory cycles. However, women with PGE using valproate within 3 years had 33% anovulatory cycles (n=18).
CONCLUSIONS: Anovulatory cycles are more common in women with PGE who receive valproate or have been on valproate within the past 3 years. Comparison by epilepsy syndrome and AED groups show an interaction effect between valproate and epilepsy syndrome. Selection of AEDs should consider preservation of reproductive health as well as seizure control.
Support: Glaxo Wellcome, Inc.
Disclosure: Grant - Glaxo Wellcome, Parke-Davis, Abbott, Pfizer; Consulting - Sanofi, Abbott, Novartis, Glaxo Wellcome; Honoraria - Glaxo Wellcome, Novartis, Parke-Davis, Elan, Cyberonics, Ortho-McNeill, Pfizer, Abbott