Valproate Use May Lead to Polycystic Ovarian Syndrome: Presented at ENDO
By Mike Fillon
NEW ORLEANS, LA -- June 18, 2004 -- Women who take the drug valproate to treat bipolar disorder may be predisposed to develop polycystic ovarian syndrome (PCOS), an endocrine disorder found in 5% to 10% of reproductive-aged women.
Many women who have PCOS have infrequent menstrual cycles together with male-pattern hair growth, acne or balding, or elevated androgen levels. The disorder is also associated with important health risks such as infertility, diabetes, and possibly heart disease, as well as precancerous growth of the lining of the uterus.
"Valproate is used widely to stabilize bipolar disorder," said lead researcher Hadine Joffe, MD, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. "Based on our findings, it is important for doctors prescribing valproate to monitor women taking the drug for signs of PCOS."
She reported the results in a poster presentation here June 16th at the 86th Annual Meeting of The Endocrine Society.
Dr. Joffe and her team examined the relationship between valproate and PCOS in women aged 18 to 45 years and diagnosed with bipolar disorder. The development of PCOS was compared between 86 women taking valproate and 143 women taking other medications including lithium, lamotrigine, topiramate, gabapentin, carbamazepine, and oxcarbazepine.
The results show that PCOS symptoms developed more commonly in women who were treated with valproate than in those who were treated with the other medications.
Nine out of 86 (10.5%) women had PCOS on valproate and in 2 out of 143 (1.4%) women taking other medications. Among women not taking valproate, 1 of 52 (1.9%) developed PCOS on lamotrigine, and 1 out of 26 (3.8%) developed PCOS on gabapentin. Menstrual cycles became infrequent within 1 year in the 9 women who developed PCOS after starting valproate.
In this cohort, 77% of the women had taken valproate at some point in their lives. Based on Dr. Jaffe's study, approximately 1 in 10 women taking valproate for bipolar disorder will develop PCOS. If the disorder develops, symptoms may disappear when valproate is stopped, but PCOS reversibility has not been fully studied, he said.
These results should help guide the evaluation and treatment of women of reproductive age who are under the care of endocrinologists and psychiatrists, Dr. Jaffe said. As valproate is a critical medication for bipolar disorder, women who develop PCOS after starting valproate should consider changing to another psychiatric drug.
This study was co-sponsored by the National Institutes of Mental Health contracts (Massachusetts General Hospital, University of Pittsburgh, and University of Texas, San Antonio) and Abbott Laboratories, Inc.
Presentation title: "Valproate Induces Oligomenorrhea and Hyperandrogenism in Women with Bipolar Disorder." Abstract #P1-546]
http://www.docguide.com/news/content.nsf/news/8525697700573E1885256EB7005FD72F 
Valproate Use May Lead to Polycystic Ovarian Syndrome 
