Epilepsy Clinical Trial
Official title:
Hormone Profiles in Adults Treated With Valproate vs. Lamotrigine Monotherapy for Newly Diagnosed Epilepsy: A Prospective Randomised Study
Both sodium valproate and lamotrigine are currently used in the treatment of newly diagnosed epilepsy. Although they appear to have similar efficacy, they have different side effects, which have not been well studied. This study aims to compare one particular aspect of their possible side effects, namely whether they affect certain hormonal functions.
Sodium valproate is an established antiepileptic drug used against a broad range of seizure
types. Lamotrigine, a newer antiepileptic drug available since late 1980s, has a similar
range of action and is approved as first-line treatment for epilepsy in the United States
and many European countries as well as in Hong Kong. Recently, concern has been raised over
the association between valproate treatment and polycystic ovarian syndrome, a condition
characterised by multiple cysts in the ovaries in women and a range of hormonal and
metabolic disturbances. Cross-sectional studies from Finland suggest that up to 40% of women
treated with valproate have polycystic ovaries. Lamotrigine substitution for valproate has
been reported to normalise these parameters in some patients. Elevated serum insulin and
androgen levels have also been reported in over 50% of male patients taking valproate for
epilepsy. However, such high incidence of hormonal abnormalities associated with valproate
treatment has not been reproduced in studies conducted in other western populations. No
similar studies in Chinese patients have been reported. In addition, these cross-sectional
studies suffer from many potential confounding factors, such as previous treatment with
other antiepileptic drugs, variation in duration of treatment, thus limiting the ability to
establish a causal relationship.
This phase IV study aims to examine whether valproate treatment is associated with hormonal
abnormalities in Chinese epilepsy patients. Newly diagnosed patients will be randomised to
receive valproate or lamotrigine and their hormonal profiles measured prospectively for 12
months.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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