ABSTRACT

We investigated polycystic ovary syndrome, insulin levels, and obesity in epileptic women on carbamazepine or valproic acid treatment.

Sex hormones (FSH, LH, progesterone, estradiol, total testosterone, and DHEAS), lipid profiles, and insulin levels were investigated in 40 epileptic women receiving carbamazepine (n=20; mean age 28 years) or valproic acid (n=20; mean age 26 years). Pelvic ultrasonography was performed in all patients. The results were compared with those of 20 healthy controls (mean age 28 years). Statistical analyses were made using Wilcoxon and Mann-Whitney U tests.

Eight patients (40%) in the valproic acid group, three patients (15%) in the carbamazepine group, and one control (5%) were found to be obese according to the Broca's index. Polycystic ovary disease was detected in six obese women (75%) receiving valproic acid, and in three women (two of whom were obese) receiving carbamazepine. No significant d i fferences were found between blood insulin levels. Valproic acid was aşociated with increased total testosterone levels, and carbamazepine with high levels of total testosterone and total cholesterol.

The increased incidences of obesity and polycystic ovary disease in the valproic acid group were attributed to drug-aşociated adverse effects.

Keywords: Anticonvulsants/adverse effects; carbamazepine/therapeutic use/adverse effects; epilepsy/blood/drug therapy; insulin/blood; obesity; polycystic ovary syndrome;sex hormones/blood/drug therapy; valproic acid/therapeutic use/adverse effect