Valproate and lamotrigine level variation with menstrual cycle phase and oral contraceptive use
To determine whether 1) combined oral contraceptive (COC) use affects serum levels of valproate (VPA) as well as lamotrigine (LTG) and 2) the naturally occurring high (mid-luteal) and low (early-mid follicular) reproductive steroid level phases of the menstrual cycle might affect antiepileptic drug...
Gespeichert in:
| Veröffentlicht in: | Neurology 2009-03, Vol.72 (10), p.911-914 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 914 |
|---|---|
| container_issue | 10 |
| container_start_page | 911 |
| container_title | Neurology |
| container_volume | 72 |
| creator | HERZOG, A. G BLUM, A. S SMITHSON, S. D DWORETZKY, B. A BROMFIELD, E. B FARINA, E. L MAESTRI, X. E NEWMAN, J GARCIA, E KRISHNAMURTHY, K. B HOCH, D. B REPLANSKY, S FOWLER, K. M |
| description | To determine whether 1) combined oral contraceptive (COC) use affects serum levels of valproate (VPA) as well as lamotrigine (LTG) and 2) the naturally occurring high (mid-luteal) and low (early-mid follicular) reproductive steroid level phases of the menstrual cycle might affect antiepileptic drug levels as well.
This investigation compared serum antiepileptic drug levels at two timepoints during a single menstrual cycle in four groups of women with epilepsy: 12 on VPA, 12 on VPA plus COC (VPA-COC), 12 on LTG, and 12 on LTG plus COC (LTG-COC).
Both VPA and LTG levels were lower (p < 0.01) on active COC than on inactive pill with median declines of 23.4% for the VPA-COC group and 32.6% for the LTG-COC group. Serum LTG levels showed a notable but not significant 31.3% median decline during the mid-luteal phase compared to the early-mid follicular phase in the non-COC group. The non-COC valproate group showed the least change of any group between the two measured timepoints with a decline of 8.3% (p = NS).
The findings suggest that valproate (VPA), like lamotrigine (LTG), has substantially and significantly lower serum levels while women take active combined oral contraceptives as compared to inactive pills. Larger sample sizes will be required to determine whether LTG levels may drop significantly also during the luteal (high steroid) phase of natural menstrual cycles and whether VPA levels may show greater stability in levels across the phases of the menstrual cycle. |
| doi_str_mv | 10.1212/01.wnl.0000344167.78102.f0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_21187343</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>21187343</sourcerecordid><originalsourceid>FETCH-LOGICAL-c378t-8ab06d9574b648806a666789cb1cd699daca42128fd109cde854e6677cc963e43</originalsourceid><addsrcrecordid>eNpFkE1r3DAQhkVoSbZp_kIRgeZmV1-W5N5KSD8g0EtbehOz8jhRke2NJG_Iv6_SXRpdBjTPO8M8hFxy1nLBxQfG28c5tqw-qRTXpjWWM9GO7IRseCd0o6X4_YpsGBO2kdbYM_Im5z-M1abpT8kZ74WRVnQb4n5B3KUFClKYBxphWkoKd2FGGnGPke4hBShhmeljKPd0wjmXtEKk_slHpLt7yIfokp4_l7kk8LgrYY90zfiWvB4hZrw41nPy8_PNj-uvze33L9-uP902XhpbGgtbpoe-M2qrlbVMg9ba2N5vuR903w_gQdXb7Thw1vsBbaewEsb7XktU8pxcHebWYx5WzMVNIXuMEWZc1uwE59ZIJSv48QD6tOSccHS7FCZIT44z96zXMe6qXvei1_3T60ZWw--OW9bthMNL9OizAu-PAGQPcUww-5D_c3W8Mp0Q8i8M2IXI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>21187343</pqid></control><display><type>article</type><title>Valproate and lamotrigine level variation with menstrual cycle phase and oral contraceptive use</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><source>Journals@Ovid Complete</source><creator>HERZOG, A. G ; BLUM, A. S ; SMITHSON, S. D ; DWORETZKY, B. A ; BROMFIELD, E. B ; FARINA, E. L ; MAESTRI, X. E ; NEWMAN, J ; GARCIA, E ; KRISHNAMURTHY, K. B ; HOCH, D. B ; REPLANSKY, S ; FOWLER, K. M</creator><creatorcontrib>HERZOG, A. G ; BLUM, A. S ; SMITHSON, S. D ; DWORETZKY, B. A ; BROMFIELD, E. B ; FARINA, E. L ; MAESTRI, X. E ; NEWMAN, J ; GARCIA, E ; KRISHNAMURTHY, K. B ; HOCH, D. B ; REPLANSKY, S ; FOWLER, K. M</creatorcontrib><description>To determine whether 1) combined oral contraceptive (COC) use affects serum levels of valproate (VPA) as well as lamotrigine (LTG) and 2) the naturally occurring high (mid-luteal) and low (early-mid follicular) reproductive steroid level phases of the menstrual cycle might affect antiepileptic drug levels as well.
This investigation compared serum antiepileptic drug levels at two timepoints during a single menstrual cycle in four groups of women with epilepsy: 12 on VPA, 12 on VPA plus COC (VPA-COC), 12 on LTG, and 12 on LTG plus COC (LTG-COC).
Both VPA and LTG levels were lower (p < 0.01) on active COC than on inactive pill with median declines of 23.4% for the VPA-COC group and 32.6% for the LTG-COC group. Serum LTG levels showed a notable but not significant 31.3% median decline during the mid-luteal phase compared to the early-mid follicular phase in the non-COC group. The non-COC valproate group showed the least change of any group between the two measured timepoints with a decline of 8.3% (p = NS).
The findings suggest that valproate (VPA), like lamotrigine (LTG), has substantially and significantly lower serum levels while women take active combined oral contraceptives as compared to inactive pills. Larger sample sizes will be required to determine whether LTG levels may drop significantly also during the luteal (high steroid) phase of natural menstrual cycles and whether VPA levels may show greater stability in levels across the phases of the menstrual cycle.</description><identifier>ISSN: 0028-3878</identifier><identifier>EISSN: 1526-632X</identifier><identifier>DOI: 10.1212/01.wnl.0000344167.78102.f0</identifier><identifier>PMID: 19273825</identifier><identifier>CODEN: NEURAI</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adolescent ; Adult ; Anticonvulsants - pharmacokinetics ; Anticonvulsants. Antiepileptics. Antiparkinson agents ; Biological and medical sciences ; Body Mass Index ; Contraceptives, Oral, Combined - adverse effects ; Drug Interactions ; Epilepsy - drug therapy ; Epilepsy - psychology ; Female ; Follicular Phase - metabolism ; Humans ; Luteal Phase - metabolism ; Medical sciences ; Menstrual Cycle - metabolism ; Middle Aged ; Neurology ; Neuropharmacology ; Pharmacology. Drug treatments ; Triazines - pharmacokinetics ; Valproic Acid - pharmacokinetics ; Young Adult</subject><ispartof>Neurology, 2009-03, Vol.72 (10), p.911-914</ispartof><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c378t-8ab06d9574b648806a666789cb1cd699daca42128fd109cde854e6677cc963e43</citedby><cites>FETCH-LOGICAL-c378t-8ab06d9574b648806a666789cb1cd699daca42128fd109cde854e6677cc963e43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21247522$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19273825$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>HERZOG, A. G</creatorcontrib><creatorcontrib>BLUM, A. S</creatorcontrib><creatorcontrib>SMITHSON, S. D</creatorcontrib><creatorcontrib>DWORETZKY, B. A</creatorcontrib><creatorcontrib>BROMFIELD, E. B</creatorcontrib><creatorcontrib>FARINA, E. L</creatorcontrib><creatorcontrib>MAESTRI, X. E</creatorcontrib><creatorcontrib>NEWMAN, J</creatorcontrib><creatorcontrib>GARCIA, E</creatorcontrib><creatorcontrib>KRISHNAMURTHY, K. B</creatorcontrib><creatorcontrib>HOCH, D. B</creatorcontrib><creatorcontrib>REPLANSKY, S</creatorcontrib><creatorcontrib>FOWLER, K. M</creatorcontrib><title>Valproate and lamotrigine level variation with menstrual cycle phase and oral contraceptive use</title><title>Neurology</title><addtitle>Neurology</addtitle><description>To determine whether 1) combined oral contraceptive (COC) use affects serum levels of valproate (VPA) as well as lamotrigine (LTG) and 2) the naturally occurring high (mid-luteal) and low (early-mid follicular) reproductive steroid level phases of the menstrual cycle might affect antiepileptic drug levels as well.
This investigation compared serum antiepileptic drug levels at two timepoints during a single menstrual cycle in four groups of women with epilepsy: 12 on VPA, 12 on VPA plus COC (VPA-COC), 12 on LTG, and 12 on LTG plus COC (LTG-COC).
Both VPA and LTG levels were lower (p < 0.01) on active COC than on inactive pill with median declines of 23.4% for the VPA-COC group and 32.6% for the LTG-COC group. Serum LTG levels showed a notable but not significant 31.3% median decline during the mid-luteal phase compared to the early-mid follicular phase in the non-COC group. The non-COC valproate group showed the least change of any group between the two measured timepoints with a decline of 8.3% (p = NS).
The findings suggest that valproate (VPA), like lamotrigine (LTG), has substantially and significantly lower serum levels while women take active combined oral contraceptives as compared to inactive pills. Larger sample sizes will be required to determine whether LTG levels may drop significantly also during the luteal (high steroid) phase of natural menstrual cycles and whether VPA levels may show greater stability in levels across the phases of the menstrual cycle.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Anticonvulsants - pharmacokinetics</subject><subject>Anticonvulsants. Antiepileptics. Antiparkinson agents</subject><subject>Biological and medical sciences</subject><subject>Body Mass Index</subject><subject>Contraceptives, Oral, Combined - adverse effects</subject><subject>Drug Interactions</subject><subject>Epilepsy - drug therapy</subject><subject>Epilepsy - psychology</subject><subject>Female</subject><subject>Follicular Phase - metabolism</subject><subject>Humans</subject><subject>Luteal Phase - metabolism</subject><subject>Medical sciences</subject><subject>Menstrual Cycle - metabolism</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Neuropharmacology</subject><subject>Pharmacology. Drug treatments</subject><subject>Triazines - pharmacokinetics</subject><subject>Valproic Acid - pharmacokinetics</subject><subject>Young Adult</subject><issn>0028-3878</issn><issn>1526-632X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkE1r3DAQhkVoSbZp_kIRgeZmV1-W5N5KSD8g0EtbehOz8jhRke2NJG_Iv6_SXRpdBjTPO8M8hFxy1nLBxQfG28c5tqw-qRTXpjWWM9GO7IRseCd0o6X4_YpsGBO2kdbYM_Im5z-M1abpT8kZ74WRVnQb4n5B3KUFClKYBxphWkoKd2FGGnGPke4hBShhmeljKPd0wjmXtEKk_slHpLt7yIfokp4_l7kk8LgrYY90zfiWvB4hZrw41nPy8_PNj-uvze33L9-uP902XhpbGgtbpoe-M2qrlbVMg9ba2N5vuR903w_gQdXb7Thw1vsBbaewEsb7XktU8pxcHebWYx5WzMVNIXuMEWZc1uwE59ZIJSv48QD6tOSccHS7FCZIT44z96zXMe6qXvei1_3T60ZWw--OW9bthMNL9OizAu-PAGQPcUww-5D_c3W8Mp0Q8i8M2IXI</recordid><startdate>20090310</startdate><enddate>20090310</enddate><creator>HERZOG, A. G</creator><creator>BLUM, A. S</creator><creator>SMITHSON, S. D</creator><creator>DWORETZKY, B. A</creator><creator>BROMFIELD, E. B</creator><creator>FARINA, E. L</creator><creator>MAESTRI, X. E</creator><creator>NEWMAN, J</creator><creator>GARCIA, E</creator><creator>KRISHNAMURTHY, K. B</creator><creator>HOCH, D. B</creator><creator>REPLANSKY, S</creator><creator>FOWLER, K. M</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope></search><sort><creationdate>20090310</creationdate><title>Valproate and lamotrigine level variation with menstrual cycle phase and oral contraceptive use</title><author>HERZOG, A. G ; BLUM, A. S ; SMITHSON, S. D ; DWORETZKY, B. A ; BROMFIELD, E. B ; FARINA, E. L ; MAESTRI, X. E ; NEWMAN, J ; GARCIA, E ; KRISHNAMURTHY, K. B ; HOCH, D. B ; REPLANSKY, S ; FOWLER, K. M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c378t-8ab06d9574b648806a666789cb1cd699daca42128fd109cde854e6677cc963e43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Anticonvulsants - pharmacokinetics</topic><topic>Anticonvulsants. Antiepileptics. Antiparkinson agents</topic><topic>Biological and medical sciences</topic><topic>Body Mass Index</topic><topic>Contraceptives, Oral, Combined - adverse effects</topic><topic>Drug Interactions</topic><topic>Epilepsy - drug therapy</topic><topic>Epilepsy - psychology</topic><topic>Female</topic><topic>Follicular Phase - metabolism</topic><topic>Humans</topic><topic>Luteal Phase - metabolism</topic><topic>Medical sciences</topic><topic>Menstrual Cycle - metabolism</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Neuropharmacology</topic><topic>Pharmacology. Drug treatments</topic><topic>Triazines - pharmacokinetics</topic><topic>Valproic Acid - pharmacokinetics</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>HERZOG, A. G</creatorcontrib><creatorcontrib>BLUM, A. S</creatorcontrib><creatorcontrib>SMITHSON, S. D</creatorcontrib><creatorcontrib>DWORETZKY, B. A</creatorcontrib><creatorcontrib>BROMFIELD, E. B</creatorcontrib><creatorcontrib>FARINA, E. L</creatorcontrib><creatorcontrib>MAESTRI, X. E</creatorcontrib><creatorcontrib>NEWMAN, J</creatorcontrib><creatorcontrib>GARCIA, E</creatorcontrib><creatorcontrib>KRISHNAMURTHY, K. B</creatorcontrib><creatorcontrib>HOCH, D. B</creatorcontrib><creatorcontrib>REPLANSKY, S</creatorcontrib><creatorcontrib>FOWLER, K. M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><jtitle>Neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>HERZOG, A. G</au><au>BLUM, A. S</au><au>SMITHSON, S. D</au><au>DWORETZKY, B. A</au><au>BROMFIELD, E. B</au><au>FARINA, E. L</au><au>MAESTRI, X. E</au><au>NEWMAN, J</au><au>GARCIA, E</au><au>KRISHNAMURTHY, K. B</au><au>HOCH, D. B</au><au>REPLANSKY, S</au><au>FOWLER, K. M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Valproate and lamotrigine level variation with menstrual cycle phase and oral contraceptive use</atitle><jtitle>Neurology</jtitle><addtitle>Neurology</addtitle><date>2009-03-10</date><risdate>2009</risdate><volume>72</volume><issue>10</issue><spage>911</spage><epage>914</epage><pages>911-914</pages><issn>0028-3878</issn><eissn>1526-632X</eissn><coden>NEURAI</coden><abstract>To determine whether 1) combined oral contraceptive (COC) use affects serum levels of valproate (VPA) as well as lamotrigine (LTG) and 2) the naturally occurring high (mid-luteal) and low (early-mid follicular) reproductive steroid level phases of the menstrual cycle might affect antiepileptic drug levels as well.
This investigation compared serum antiepileptic drug levels at two timepoints during a single menstrual cycle in four groups of women with epilepsy: 12 on VPA, 12 on VPA plus COC (VPA-COC), 12 on LTG, and 12 on LTG plus COC (LTG-COC).
Both VPA and LTG levels were lower (p < 0.01) on active COC than on inactive pill with median declines of 23.4% for the VPA-COC group and 32.6% for the LTG-COC group. Serum LTG levels showed a notable but not significant 31.3% median decline during the mid-luteal phase compared to the early-mid follicular phase in the non-COC group. The non-COC valproate group showed the least change of any group between the two measured timepoints with a decline of 8.3% (p = NS).
The findings suggest that valproate (VPA), like lamotrigine (LTG), has substantially and significantly lower serum levels while women take active combined oral contraceptives as compared to inactive pills. Larger sample sizes will be required to determine whether LTG levels may drop significantly also during the luteal (high steroid) phase of natural menstrual cycles and whether VPA levels may show greater stability in levels across the phases of the menstrual cycle.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>19273825</pmid><doi>10.1212/01.wnl.0000344167.78102.f0</doi><tpages>4</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0028-3878 |
| ispartof | Neurology, 2009-03, Vol.72 (10), p.911-914 |
| issn | 0028-3878 1526-632X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_21187343 |
| source | MEDLINE; Alma/SFX Local Collection; Journals@Ovid Complete |
| subjects | Adolescent Adult Anticonvulsants - pharmacokinetics Anticonvulsants. Antiepileptics. Antiparkinson agents Biological and medical sciences Body Mass Index Contraceptives, Oral, Combined - adverse effects Drug Interactions Epilepsy - drug therapy Epilepsy - psychology Female Follicular Phase - metabolism Humans Luteal Phase - metabolism Medical sciences Menstrual Cycle - metabolism Middle Aged Neurology Neuropharmacology Pharmacology. Drug treatments Triazines - pharmacokinetics Valproic Acid - pharmacokinetics Young Adult |
| title | Valproate and lamotrigine level variation with menstrual cycle phase and oral contraceptive use |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-09T15%3A02%3A32IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Valproate%20and%20lamotrigine%20level%20variation%20with%20menstrual%20cycle%20phase%20and%20oral%20contraceptive%20use&rft.jtitle=Neurology&rft.au=HERZOG,%20A.%20G&rft.date=2009-03-10&rft.volume=72&rft.issue=10&rft.spage=911&rft.epage=914&rft.pages=911-914&rft.issn=0028-3878&rft.eissn=1526-632X&rft.coden=NEURAI&rft_id=info:doi/10.1212/01.wnl.0000344167.78102.f0&rft_dat=%3Cproquest_cross%3E21187343%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=21187343&rft_id=info:pmid/19273825&rfr_iscdi=true |