Therapy for epilepsy in women: Additional sanogenetic effect caused by the intake of topiramate
Objective: to investigate the efficacy/tolerability of topiramate in reproductive-aged women. Subjects and methods. A group of 58 patients in fertile age (18-35 years) with a long history of focal (n=44) or idiopathic generalized (n=14) epilepsy (FE and IGE) who received mainly combined therapy with 2 antiepileptic drugs (AEDs) was analyzed. 82.8% of the patients were overweight; 51.7% had one or other menstrual cycle disorders; however, the women had been followed up by a gynecologist in exceptional cases. Results. Switch from one of the parent AEDs to topiramate or its incorporation into a treatment regimen as an additional drug substantially improved the course of the disease: remission at 12 months was achieved in 59.1% of the patients with FE and 78.6% of those with IGE. 29.3% of the patients receiving dual therapy, the second medication of which was topiramate, were observed to have lost weight not only if those had high baseline body mass index (BMI), but also if those had normal BMI at baseline. 8.6% of all the patients and 16.7% of those with menstrual cycle disorder achieved normalization of menstrual function. Topiramate was discontinued only in 1 (1.7%) patient because of critical weight loss (BMI<15). In addition to substantial improvement, topiramate used in mono- or dual therapy for FE and IGE may normalize weight and a menstrual cycle. Menstrual function is indicated to be monitored in epileptic women.