Hyperandrogenism as a side effect of anticonvulsants

Abstract

Aim: confirm the connection between hyperandrogenism and side effects of antiepileptic drugs in women. Materials andMethods. Body weight, the menstrual cycle periodicity and the blood concentration of dihydrotestosterone were monitored in 278 women taking various antiepileptic drugs (valproic acid, carbamazepine, lamotrigine, topiramate, and levetiracetam). The measurements were made at 3, 6, and 12 month after the treatment began.Results. Among women taking valproic acid for 12 months, the average weight gain was 14.4%, and in the group of carbamazepine – 5.4%. In women taking lamotrigine and levetiracetam, the weight gain did not exceed 1.2%. With topiramate, a decrease in the body weight by 1.4% was found. Among women taking valproic acid, the occurrence rate of menstrual cycle disorders increased by 64.9% after 12 months of treatment. In women taking carbamazepine the increase was 22.6%. In the other groups, this increase did not exceed 3.7%. The occurrence of menstrual cycle disorders correlated with an increase in the level of dihydrotestosterone. In women taking valproic acid, an increase in the concentration of blood dihydrotestosterone from 256.8 pg/ml to 526.32 pg/ml was found at the time-point of 12 months. In the group taking carbamazepine, an increase in the concentration of dihydrotestosterone from 268.4 pg/ml to 354.4 pg/ml was noted. In the other groups, fluctuations in the concentration of dihydrotestosterone were insignificant.Conclusion. The body weight gain and the menstrual cycle disorders during anticonvulsant therapy are associated with hyperandrogenism.