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Women's Health: Drug choice influences risk of hormonal problems in epilepsy

Women with the seizure disorder are at higher risk for polycystic ovary syndrome, but certain medications may help

Although women with epilepsy are at increased risk for developing a hormonal disorder called polycystic ovary syndrome (PCOS), the choice of anti-seizure medication may be important in lowering that risk.

Women with PCOS have high levels of male hormones, missed or irregular periods, and many small fluid-filled sacs in their ovaries.

Dr. Frances Hayes of the Massachusetts General Hospital in Boston studied how often these problems developed in 300 women who were randomly assigned to take either of two epilepsy drugs: valproic acid or lamotrigine.

Over a one-year period, seven per cent of women who took valproic acid developed PCOS, compared with only one per cent of women taking lamotrigine. And 36 per cent of valproic acid patients developed either abnormal periods or symptoms of elevated male hormones, compared with 23 per cent of lamotrigine patients. These risks were higher in women under 25 years of age who were taking valproic acid.

Hayes says the study results indicate that the choice of anti-seizure medication has important implications for the development of PCOS in women with epilepsy. Although valproic acid is effective at reducing the occurrence of seizures, she suggests that younger women with epilepsy should consider other medications. “If there’s an alternative agent that’s equally effective I would probably use it.”

The study was sponsored by GlaxoSmithKline, which makes lamotrigine under the brand name Lamictal.