Neuroendocrine considerations in the treatment of men and women with epilepsy

Summary Complex, multidirectional interactions between hormones, seizures, and the medications used to control them can present a challenge for clinicians treating patients with epilepsy. Many hormones act as neurosteroids, modulating brain excitability via direct binding sites. Thus, changes in end...

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Bibliographic Details
Published in:Lancet neurology 2013, Vol.12 (1), p.72-83
Main Authors: Harden, Cynthia L, Prof, Pennell, Page B, MD
Format: Article
Language:English
Subjects:
Anticonvulsants - adverse effects
Anticonvulsants - metabolism
Anticonvulsants - therapeutic use
Antiepileptic agents
Brain
Brain - drug effects
Brain - metabolism
Brain - physiopathology
Epilepsy
Epilepsy - drug therapy
Epilepsy - metabolism
Epilepsy - physiopathology
Excitability
Female
Hormones
Humans
Hypothalamus
Male
Neurology
Neurosteroids
Neurotransmitter Agents - adverse effects
Neurotransmitter Agents - metabolism
Neurotransmitter Agents - therapeutic use
Pharmacokinetics
Reproduction - drug effects
Reproduction - physiology
Seizures
Treatment Outcome
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Summary:Summary Complex, multidirectional interactions between hormones, seizures, and the medications used to control them can present a challenge for clinicians treating patients with epilepsy. Many hormones act as neurosteroids, modulating brain excitability via direct binding sites. Thus, changes in endogenous or exogenous hormone levels can affect the occurrence of seizures directly as well as indirectly through pharmacokinetic effects that alter the concentrations of antiepileptic drugs. The underlying structural and physiological brain abnormalities of epilepsy and the metabolic activity of antiepileptic drugs can adversely affect hypothalamic and gonadal functioning. Knowledge of these complex interactions has increased and can now be incorporated in meaningful treatment approaches for men and women with epilepsy.
ISSN:1474-4422
1474-4465
DOI:10.1016/S1474-4422(12)70239-9