Background
In the Systematic Treatment Enhancement Program for Bipolar Disorder, we showed that
valproate is associated with new-onset menstrual-cycle irregularities and hyperandrogenism
in 10.5% of 86 women. We now determine whether polycystic ovarian syndrome (PCOS)
features reverse on valproate discontinutation.
Methods
Women with valproate-associated PCOS and those at risk for PCOS (valproate use ≤6
months) were re-evaluated for PCOS.
Results
Follow-up (mean 17 months) assessments were completed in 14 women (5 with treatment-emergent
PCOS, 9 on valproate ≤6-month). Of seven women who developed valproate-associated
PCOS, PCOS reproductive features remitted in three of four discontinuing valproate
and persisted in all 3 continuing valproate. Menstrual-cycle irregularities improved
among valproate-discontinuers whose PCOS features remitted (p = 0.01). There was a
trend toward lower serum testosterone (p = 0.06). Body-weight and polycystic ovarian
morphology did not change.
Conclusions
In the first longitudinal bipolar-disorder study of valproate-associated PCOS, most
valproate-discontinuers had improved reproductive features of PCOS despite static
body-weight.
Key Words
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Article info
Publication history
Published online: September 04, 2006
Accepted:
May 12,
2006
Received in revised form:
May 10,
2006
Received:
January 12,
2006
Identification
Copyright
© 2006 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
