Progesterone therapy in women with epilepsy

Background: progesterone with its anti-seizure effect plays a role in the pathophysiology of catamenial epilepsy which affects 31-60% of epileptic women. in this study,an attempt to treat women suffering from catamenial epilepsy with progesterone,as an adjuvant drug,was made. methods: the treatment was given to 36 women aged 20-40 years (mean age: 30.75 ± 6.05) with seizures in the entire second half of the menstrual cycle,who were found to have low serum levels of progesterone on days 22,27,28 of the cycle in comparison with a control group of healthy women. the patients were administered progesterone in a daily dose of 50 mg on days 16-25 of each cycle. the serum levels of antiepileptic drugs were assayed. the period of progesterone therapy ranged from 3 to 45 months (17.7 on average). results: three patients were free of secondary generalized seizures,and one - of simple partial seizures. adecline in the frequency of primary and secondary generalized seizures by 20-96% (55.9% on average) was accomplished in 18 patients (primary generalized by 20-96% - 54.7% on average,and secondarily generalized by 38-85% - 59% on average).adecline in the frequency of complex partial seizures by 38-87% (63.1% on average) was achieved in 15 women. in 1 patient,the frequency of myoclonic seizures decreased by 46%. there was no improvement in 5 women (3 patients with generalized,1 with complex partial and 1 with simple partial seizures). an exacerbation of seizure frequency occurred in 5 patients. adverse effects were not found in any of the subjects. the average concentrations of antiepileptic drugs during hormonal therapy were in the therapeutic range. conclusion: progesterone combined with antiepileptic therapy was well tolerated and resulted in a significant reduction of seizure frequency in majority of patients with catamenial epilepsy. copyright © 2013 by institute of pharmacology polish academy of sciences.