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Reproductive Hormones in Epilepsy Therapy: From Old Promises to New Hopes

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Part of the book series: Contemporary Clinical Neuroscience ((CCNE))

Abstract

A significant mutual interaction between sex hormones and the central nervous system has been reported by several studies in the past years.

This paper aims to discuss the genomic and electrophysiological effects of androgens, estrogens and progestogens on neurons, their influence on seizure frequency and antiepileptic drugs metabolism, and, conversely, the hormonal changes and reproductive dysfunction in patients with epilepsy.

In conclusion, the correlations between Polycystic Ovary Syndrome (PCOS), reduced effectiveness of contraceptives and antiepileptic drugs have also been mentioned.

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Refrences

  • Bartoli A, Gatti G, Cipolla G, Barzaghi N, Veliz G, Fattore C, Mumford J, Perucca E (1997) A double-blind, placebo-controlled study on the effect of vigabatrin on in vivo parameters of hepatic microsomal enzyme induction and on the kinetics of steroid oral contraceptives in healthy female volunteers. Epilepsia 38:702–707

    Article  CAS  PubMed  Google Scholar 

  • Bauer J, Isojärvi JI, Herzo AG, Reuber M, Polson D, Taubøll E, Genton P, van der Ven H, Roesing B, Luef GJ, Galimberti CA, van Parys J, Flügel D, Bergmann A, Elger CE (2002) Reproductive dysfunction in women with epilepsy: recommendations for evaluation and management. J Neurol Neurosurg Psychiatry 73:121–125

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Belcastro V, D’Egidio C, Striano P, Verrotti A (2013) Metabolic and endocrine effects of valproic acid chronic treatment. Epilepsy Res 107:1–8

    Article  CAS  PubMed  Google Scholar 

  • Betts T, Yarrow H, Dutton N, Greenhill L, Rolfe T (2003) A study of anticonvulsant medication on ovarian function in a group of women with epilepsy who have only ever taken one anticonvulsant compared with a group of women without epilepsy. Seizure 12:323–329

    Article  PubMed  Google Scholar 

  • Chen SS, Shen MR, Chen TJ, Lai SL (1992) Effects of antiepileptic drugs on sperm motility of normal controls and epileptic patients with long-term therapy. Epilepsia 33:149–153

    Article  CAS  PubMed  Google Scholar 

  • Ciampani M, Verrotti A, Chiarelli F (2005) Sex hormones in patients with epilepsy-hormonal changes in epileptic men and women taking antiepileptics. Horm Metab Res 37:184–188

    Article  CAS  PubMed  Google Scholar 

  • Drislane FW, Coleman AE, Schomer DL, Ives J, Levesque LA, Seibel MM, Herzog AG (1994) Altered pulsatile secretion of luteinizing hormone in women with epilepsy. Neurology 44:306–310

    Article  CAS  PubMed  Google Scholar 

  • Duncan S, Talbot A, Sheldrick R, Caswell H (2009) Erectile function, sexual desire, and psychological well-being in men with epilepsy. Epilepsy Behav 15:351–357

    Article  PubMed  Google Scholar 

  • Erel T, Guralp O (2011) Epilepsy and menopause. Arch Gynecol Obstet 284:749–755

    Article  PubMed  Google Scholar 

  • Evans JL, Goldfine ID, Maddux BA, Grodsky GM. (2003) Are oxidative stress-activated signaling pathways mediators ofinsulin resistance and beta-cell dysfunction? Diabetes 52:1–8

    Article  CAS  PubMed  Google Scholar 

  • Fawley JA, Pouliot WA, Dudek FE (2006) Epilepsy and reproductive disorders: the role of the gonadotropin-releasing hormone network. Epilepsy Behav 8:477–482

    Article  PubMed  Google Scholar 

  • Finocchi C, Ferrari M (2011) Female reproductive steroids and neuronal excitability. Neurol Sci 32(Suppl 1):S31–35

    Article  Google Scholar 

  • Foldvary-Schaefer N, Harden C, Herzog A, Falcone T (2004) Hormones and seizures. Cleve Clin J Med 71(Suppl 2):S11–18

    Article  Google Scholar 

  • Greco R, Latini G, Chiarelli F, Iannetti P, Verrotti A (2005) Leptin, ghrelin, and adiponectin in epileptic patients treatedwith valproic acid. Neurology 65:1808–1809

    Article  CAS  PubMed  Google Scholar 

  • Guberman A (1999) Hormonal contraception and epilepsy. Neurology 53:S38–40

    Article  Google Scholar 

  • Guille C, Spencer S, Cavus I, Epperson CN (2008) The role of sex steroids in catamenial epilepsy and premenstrual dysphoric disorder: implications for diagnosis and treatment. Epilepsy Behav 13:12–24

    Article  PubMed Central  PubMed  Google Scholar 

  • Gungor S, Yücel G, Akinci A, Tabel Y, Ozerol IH, Yologlu S (2007) The role of ghrelin in weight gain and growth in epileptic children using valproate. J Child Neurol 22:1384–1388

    Article  PubMed  Google Scholar 

  • Hamed SA (2008) Neuroendocrine hormonal conditions in epilepsy: relationship to reproductive and sexual functions. Neurologist 14:157–169

    Article  PubMed  Google Scholar 

  • Harden CL (2003) Menopause and bone density issues for women with epilepsy. Neurology 61:S16–S22

    Article  Google Scholar 

  • Harden CL (2008) Sexual dysfunction in women with epilepsy. Seizure 17:131–135

    Article  PubMed  Google Scholar 

  • Herzog AG (1986) Intermittent progesterone therapy of partial complex seizures in women with menstrual disorders. Neurology 36:1607–1610

    Article  CAS  PubMed  Google Scholar 

  • Herzog AG (1995) Progesterone therapy in women with complex partial and secondary generalized seizures. Neurology 45:1660–1662

    Article  CAS  PubMed  Google Scholar 

  • Herzog AG (1999) Progesterone therapy in women with epilepsy: a 3-year follow-up. Neurology 52:1917–1918

    Article  CAS  PubMed  Google Scholar 

  • Herzog AG (2008) Disorders of reproduction in patients with epilepsy: primary neurological mechanisms. Seizure 17:101–110

    Article  PubMed  Google Scholar 

  • Herzog AG, Seibel MM, Schomer DL Vaitukaitis JL, Geschwind N (1986) Reproductive endocrine disorders in women with partial seizures of temporal lobe origin. Arch Neurol 43:341–346

    Article  CAS  PubMed  Google Scholar 

  • Herzog AG, Klein P, Ransil BJ (1997) Three patterns of catamenial. Epilepsia 38:1082–1088

    Article  CAS  PubMed  Google Scholar 

  • Herzog AG, Coleman AE, Jacobs AR, Klein P, Friedman MN, Drislane FW, Ransil BJ, Schomer DL (2003) Interictal EEG discharges, reproductive hormones, and menstrual disorders in epilepsy. Ann Neurol 54:625–637

    Article  PubMed  Google Scholar 

  • Isojärvi JI, Laatikainen TJ, Pakarinen AJ, Juntunen KT, Myllylä VV (1993) Polycystic ovaries and hyperandrogenism in women taking valproate for epilepsy. N Engl J Med 329:1383–1388

    Article  PubMed  Google Scholar 

  • Isojärvi JI, Laatikainen TJ, Pakarinen AJ, Juntunen KT, Myllylä VV (1995) Menstrual disorders in women with epilepsy receiving carbamazepine. Epilepsia 36:676–681

    Article  PubMed  Google Scholar 

  • Isojärvi JI, Laatikainen TJ, Knip M, Pakarinen AJ, Juntunen KT, Myllylä VV (1996) Obesity and endocrine disorders in women taking valproate for epilepsy. Ann Neurol 39:579–584

    Article  PubMed  Google Scholar 

  • Isojärvi JI, Rättyä J, Myllylä VV, Knip M, Koivunen R, Pakarinen AJ, Tekay A, Tapanainen JS (1998) Valproate, lamotrigine, and insulinmediated risks in women with epilepsy. Ann Neurol 43:446–451

    Article  PubMed  Google Scholar 

  • Isojärvi JI, Taubøll E, Pakarinen AJ, van Parys J, Rättyä J, Harbo HF, Dale PO, Fauser BC, Gjerstad L, Koivunen R, Knip M, Tapanainen JS (2001) Altered ovarian function and cardiovascular risk factors in valproate-treated women. Am J Med 111:290–296

    Article  PubMed  Google Scholar 

  • Isojärvi JI, Taubøll E, Herzog AG (2005) Effect of antiepileptic drugs on eproductive endocrine function in individuals with epilepsy. CNS Drugs 19:207–223

    Article  PubMed  Google Scholar 

  • Keefe DL (2002) Sex hormones and neural mechanisms. Arch Sex Behav 31:401–403

    Article  PubMed  Google Scholar 

  • Klein P, Serje A, Pezzullo JC (2001) Premature ovarian failure in women with epilepsy. Epilepsia 42:1584–1589

    Article  CAS  PubMed  Google Scholar 

  • Lim LL, Foldvary N, Mascha E, Lee J (2001) Acetazolamide in women with catamenial epilepsy. Epilepsia 42:746–749

    Article  CAS  PubMed  Google Scholar 

  • Luef G, Abraham I, Trinka E, Alge A, Windisch J, Daxenbichler G, Unterberger I, Seppi K, Lechleitner M, Krämer G, Bauer G. (2002) Hyperandrogenism, postprandial hyperinsulinism and the risk of PCOS in a cross sectional study of women with epilepsy treated with valproate. Epilepsy Res 48:91–102

    Article  CAS  PubMed  Google Scholar 

  • Luef G, Lechleitner M, Bauer G, Trinka E, Hengster P (2003) Valproic acid modulates islet cell insulin secretion: a possible mechanism of weight gain in epilepsy patients. Epilepsy Res 55:53–58

    Article  CAS  PubMed  Google Scholar 

  • Luef G, Rauchenzauner M, Waldmann M, Sturm W, Sandhofer A, Seppi K, Trinka E, Unterberger I, Ebenbichler CF, Joannidis M, Walser G, Bauer G, Hoppichler F, Lechleitner M (2009) Non-alcoholic fatty liver disease (NAFLD), insulin resistance and lipid profile in antiepileptic drugtreatment. Epilepsy Res 86:42–47

    Article  CAS  PubMed  Google Scholar 

  • Mattson RH, Cramer JA, Caldwell BV, Siconolfi BC (1984) Treatment of seizures with medroxyprogesterone acetate: preliminary report. Neurology 34:1255–1258

    Article  CAS  PubMed  Google Scholar 

  • McAuley JW, Moore JL, Reeves AL, Flyak J, Monaghan EP, Data J (2001) A pilot study of the neurosteroid ganaxolone in catamenial epilepsy: clinical experience in two patients. Epilepsia 42:85–85

    Google Scholar 

  • Morell MJ (2003) Reproductive and metabolic disorders in women with epilepsy. Epilepsia 44:11–20

    Article  Google Scholar 

  • Morrell MJ, Giudice L, Flynn KL, Seale CG, Paulson AJ, Doñe S, Flaster E, Ferin M, Sauer MV (2002) Predictors of ovulatory failure in women with epilepsy. Ann Neurol 52:704–711

    Article  PubMed  Google Scholar 

  • Morrell MJ, Flynn KL, Doñe S, Flaster E, Kalayjian L, Pack AM (2005) Sexual dysfunction, sex steroid hormone abnormalities, and depression in women with epilepsy treated with antiepileptic drugs. Epilepsy Behav 6:360–365

    Article  PubMed  Google Scholar 

  • Morrell MJ, Hayes FJ, Sluss PM, Adams JM, Bhatt M, Ozkara C, Warnock CR, Isojärvi J (2008) Hyperandrogenism, ovulatory dysfunction, and polycystic ovary syndrome with valproate versus lamotrigine. Ann Neurol 64:200–211

    Article  CAS  PubMed  Google Scholar 

  • Pack AM (2010) Implications of hormonal and neuroendocrine changes associated with seizures and antiepileptic drugs: a clinical perspective. Epilepsia 51(Suppl 3):150–153

    Article  PubMed  Google Scholar 

  • Pennell PB (2009) Hormonal aspects of epilepsy. Neurol Clin 27:941–965

    Article  PubMed Central  PubMed  Google Scholar 

  • Prabhakar S, Sahota P, Kharbanda PS, Siali R, Jain V, Lal V, Khurana D (2007) Sodium valproate, hyperandrogenism and altered ovarian function in Indian women with epilepsy: a prospective study. Epilepsia 48:1371–1377

    Article  CAS  PubMed  Google Scholar 

  • Quigg M, Smithson SD, Fowler KM, Sursal T, Herzog AG (2009) Laterality and location influence catamenial seizure expression in women with partial epilepsy. Neurology 73:223–227

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Rauchenzauner M, Haberlandt E, Scholl-Bürgi S, Karall D, Schoenherr E, Tatarczyk T, Engl J, Laimer M, Luef G, Ebenbichler CF (2008) Effect of valproic acid treatment on body composition, leptin and the soluble leptin receptor in epileptic children. Epilepsy Res 80:142–149

    Article  CAS  PubMed  Google Scholar 

  • Rauchenzauner M, Bitsche G, Svalheim S, Tauboll E, Haberlandt E, Wildt L, Rostasy K, Luef G (2010) Effects of levetiracetam and valproic acid monotherapy on sex-steroid hormones in prepubertal children—results from a pilot study. Epilepsy Res 88:264–268

    Article  CAS  PubMed  Google Scholar 

  • Reddy DS (2009) The role of neurosteroids in the pathophysiology and treatment of catamenial epilepsy. Epilepsy Res 85:1–30

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Reddy DS, Rogawski MA (2009) Neurosteroid replacement therapy for catamenial epilepsy. Neurotherapeutics 6:392–401

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Ross IP (1958) Acetazolamide therapy in epilepsy. Lancet 2:1308–1309

    Article  CAS  PubMed  Google Scholar 

  • Røste LS, Taubøll E, Svalheim S, Gjerstad L (2008) Does menopause affect the epilepsy? Seizure 17:172–175

    Article  PubMed  Google Scholar 

  • Scharfman HE, Kim MK, Hintz TM, MacLusky NJ (2008) Seizures and reproductive function: insights from female rats with epilepsy. Ann Neurol 64:687–697

    Article  PubMed Central  PubMed  Google Scholar 

  • Verrotti A, Basciani F, Morresi S, de Martino M, Morgese G, Chiarelli F (1999) Serum leptin changes in epileptic patients who gain weight after therapy with valproic acid. Neurology 53:230–232

    Article  CAS  PubMed  Google Scholar 

  • Verrotti A, Manco R, Agostinelli S, Coppola G, Chiarelli F (2010) The metabolic syndrome in overweight epileptic patients treated with valproic acid. Epilepsia 51:268–273

    Article  CAS  PubMed  Google Scholar 

  • Verrotti A, D’Egidio C, Mohn A, Coppola G, Parisi P, Chiarelli F (2011) Antiepileptic drugs, sex hormones, and PCOS. Epilepsia 52:199–211

    Article  CAS  PubMed  Google Scholar 

  • Wong HY, Chu TS, Lai JC, Fung KP, Fok TF, Fujii T (2005) Sodium valproate inhibits glucose transport and exacerbates Glut1-deficiency in vitro. J Cell Biochem 96:775–785

    Article  CAS  PubMed  Google Scholar 

  • Xiaotian X, Hengzhong Z, Yao X, Zhipan Z, Daoliang X, Yumei W (2013) Effects of antiepileptic drugs on reproductive endocrine function, sexual function and sperm parameters in Chinese Han men with epilepsy. J Clin Neurosci 20:1492–1497

    Article  PubMed  Google Scholar 

  • Zimmerman AW, Holder DT, Reiter EO, Dekaban AS (1973) Medroxyprogesterone acetate in the treatment of seizures associated with menstruation. J Pediatr 83:959–963

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Alberto Verrotti .

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Verrotti, A., Prezioso, G., D’Egidio, C., Belcastro, V. (2015). Reproductive Hormones in Epilepsy Therapy: From Old Promises to New Hopes. In: Striano, P. (eds) Epilepsy Towards the Next Decade. Contemporary Clinical Neuroscience. Springer, Cham. https://doi.org/10.1007/978-3-319-12283-0_11

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