Polycystic ovary syndrome in women using valproate: a review.

Valproate (VPA) is a highly effective drug successfully employed in several neuropsychiatric diseases. In the last 15 years, an increased prevalence of polycystic ovary syndrome (PCOS) associated with VPA use has been reported in both women with epilepsy and women with bipolar disorders. However, data on this subject are contrasting and it is possible that different factors might play a role in the development of PCOS in these patients. The risk of developing PCOS during VPA treatment seems to be higher in women with epilepsy than in women with bipolar disorders, and this might be due to an underlying neuroendocrine dysfunction related to the seizure disorder. Gynecologists must be aware of the possibility that PCOS in these populations of patients might be related to VPA use, and a careful multi-specialist approach is required for evaluating the risks and benefits of this treatment in the presence of features of PCOS

Topiramate as add-on therapy in drug-resistant localization-related epilepsies: efficacy and tolerability

RATIONALE: The aim of this study is to investigate efficacy and tolerability of topiramate (TPM) add-on therapy in Drug resistant (DR) Localization Related Epilepsies. METHODS: Forty-two patients (22 M and 20 F) affected by DR Localization Related Epilepsies entered the study after informed consent. Mean age was 32.3 years (range 17-59). Twenty four patients (57.1%) were affected by Symptomatic Localization Related Epilepsies and 18 (42.9%) by Cryptogenic Localization Related Epilepsies. All patients were already treated with 14 antiepileptic drugs (AEDs) with plasma levels within therapeutic ranges. TPM was given as add-on treatment with doses ranging from 150 to 600 mg/day. After TPM titration all patients entered a follow-up period lasting at least 6 months (mean 9.8 months). Patients were considered responders when seizures showed a 2 50% reduction with respect to the 6-month period preceding TPM add-on. RESULTS: In the whole group responders were 26 (61.9%) with 3 patients (7.1%) completely seizure free. No significant differences in seizure response were observed between Symptomatic and Cryptogenic Epilepsies. Side effects were reported in 13 patients (31.0%), consisting mainly of weight reduction. This phenomenon was generally transient and did not lead to discontinuation of TPM therapy. CONCLUSIONS: TPM add-on treatment showed a good efficacy and tolerability in DR Localization Related Epilepsies. The most frequent side effect was weight reduction