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| |  ISP: Valproic Acid Linked To Endocrine Abnormalities In Women With Bipolar Disorder By Alison Palkhivala Special to DG News
QUEBEC CITY, QC -- August 9, 2001 -- Valproic acid may not be the best treatment option for women of reproductive age with bipolar disorder. Roger McIntyre, MD, and colleagues from the department of psychiatry at the University of Toronto, in Toronto, Ontario, Canada, have demonstrated that the drug is more likely than lithium to cause endocrine and menstrual abnormalities in women with bipolar disorder. The findings were presented this week in Quebec City, Quebec, Canada, in a poster session at the 32nd Annual Meeting of the International Society of Psychoneuroendocrinology. Previous research has demonstrated that individuals with bipolar disorder are at increased risk for being overweight as well as having several of the risk factors for cardiovascular disease. It is unclear the degree to which medication contributes to this problem. The long-term side effects of valproic acid, which is used in both epilepsy and bipolar disorder, are a particular concern in women of reproductive age because it has already been linked to the development of polycystic ovarian syndrome. Dr. McIntyre and colleagues evaluated 38 women, aged 18 to 50, with bipolar I or II disorder, 18 of whom were treated with valproic acid and 20 of whom were treated with lithium. The participants completed questionnaires about menstrual, reproductive, and medical histories. All patients underwent a physical assessment during the follicular phase of their menstrual cycle that included measurement of their body mass index (BMI) as well as multiple blood tests to measure endocrine and other metabolic functioning. Women taking valproic acid were more likely than those on lithium to report having menstrual abnormalities (50 percent vs. 15 percent). Half of overweight women with menstrual abnormalities also had hyperandrogenism. Blood tests revealed higher levels of androgens and leptin among women taking valproic acid. The investigators concluded that valproic acid places women who have bipolar disorder at increased risk for menstrual abnormalities and hyperandrogenism. These findings should be taken into consideration by clinicians selecting a treatment option for women of reproductive age with bipolar disorder, they added.
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