Valproate-associated reproductive and metabolic abnormalities: are epileptic women at greater risk than bipolar women?

Akdeniz, Fisun; Taneli, Fatma; Noyan, Ayşın; Vahip, Simavi

doi:10.1016/s0278-5846(02)00341-x

Cited by 38 publications

(34 citation statements)

References 23 publications

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“…[4][5][6][7][8]10 Another study from the Rasgon group 5 assessed mood, medication use, and life-event data prospectively for three consecutive menstrual cycles in 17 women with BD who were being treated with moodstabilizing medication. Oligomenorrhea was observed in 18% of women in the study, whereas amenorrhea was not.…”

Section: Menstrual Abnormalitiesmentioning

confidence: 99%

“…[6][7][8]10 In a study of 38 women with BD who were receiving treatment with VPA or lithium, McIntyre and colleagues 7 observed MAs, including amenorrhea, oligomenorrhea, and prolonged or irregular cycles, in half of the women treated with VPA and 15% of those treated with lithium. A high rate (47%) of MAs among women with BD treated with VPA was also reported by O'Donovan and colleagues.…”

Section: Menstrual Abnormalitiesmentioning

confidence: 99%

“…6 In a study of women treated with VPA for either BD or epilepsy, 20% of women with BD reported MAs, compared to 47% in women with epilepsy. 8 Recently, longitudinal follow-up data from 230 women evaluated in the Systematic Treatment Enhancement Program for Bipolar Disorder showed development of oligomenorrhea with hyperandrogenism in 1.4% of women treated with either lithium or a non-VPA anticonvulsant and in nearly 10.5% of women treated with VPA. 10 In addition, oligomenorrhea always began within 12 months of VPA use.…”

Section: Menstrual Abnormalitiesmentioning

confidence: 99%

“…Studies that have specifically addressed the association between psychotropic medications, on the one hand, and menstrual abnormalities, polycystic ovary syndrome (PCOS), and overall reproductive endocrine function in women with BD, on the other, have reported overall high rates of HPG Reproductive and Metabolic Abnormalities in Bipolar Disorder 139 irregularities in women with BD and also an especially deleterious clinical picture for patients treated with valproic acid (VPA). [3][4][5][6][7][8][9][10] These studies have particularly noted menstrual abnormalities in the form of amenorrhea (absence of menstrual period), oligomenorrhea (infrequent uterine bleeding episodes with intervals of more than 35 days), and irregular cycles. Yet, there is also evidence of reproductive dysfunction in women with BD prior to treatment.…”

mentioning

confidence: 99%

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Reproductive and Metabolic Abnormalities Associated with Bipolar Disorder and Its Treatment

Kenna

Jiang

Rasgon

2009

Harvard Review of Psychiatry

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Women with mood disorders, especially bipolar disorder (BD), have been shown to have high rates of reproductive and metabolic dysfunction. The available data on the functional, anatomic, and clinical neuroendocrine abnormalities in women with BD suggest a two-tiered relationship with mood pathology. First, many of the medications commonly used in the treatment of BD can have deleterious effects on blood levels of reproductive hormones and consequently on the hypothalamic-pituitary-gonadal (HPG) axis and reproductive function. Studies that have specifically addressed the association between psychotropic medications and menstrual abnormalities, polycystic ovary syndrome, and overall reproductive endocrine function in women with BD have found high rates of HPG irregularities in women with BD. Second, there is evidence of reproductive dysfunction in women with BD prior to treatment. In addition, many of the psychotropic medications used in the treatment of BD are associated with weight gain, insulin resistance, and dyslipidemia. These metabolic side effects further compound the neuroendocrine system dysregulation in women with BD. Current understanding of the reproductive and metabolic function in women with BD points to vulnerability, which in turn increases the risk of later-life cardiovascular disease and diabetes, among other morbidities, for women with BD.

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Section: Menstrual Abnormalitiesmentioning

confidence: 99%

Section: Menstrual Abnormalitiesmentioning

confidence: 99%

Section: Menstrual Abnormalitiesmentioning

confidence: 99%

mentioning

confidence: 99%

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Reproductive and Metabolic Abnormalities Associated with Bipolar Disorder and Its Treatment

Kenna

Jiang

Rasgon

2009

Harvard Review of Psychiatry

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“…Akdeniz et al [25] evaluated the association between valproate and reproductive abnormalities in 30 women with bipolar disorder who were treated with valproate monotherapy, lithium monotherapy, or valproate-lithium combination therapy and in 15 women with idiopathic generalized epilepsy (IGE) receiving valproate monotherapy. None of the patients on lithium reported menstrual disturbances.…”

Section: Valproatementioning

confidence: 99%

Weight gain and metabolic issues of medicines used for bipolar disorder

Fagiolini

Chengappa²

2007

Curr Psychiatry Rep

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Patients with bipolar disorder are at high risk of gaining weight and developing metabolic illnesses, and pharmacologic treatment for the disorder may significantly increase this risk. This paper reviews the literature on the metabolic consequences of the medications used in bipolar disorder and describes the possible strategies to prevent, monitor, and treat the common metabolic illnesses that patients with bipolar disorder may develop during treatment.

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