Effects of long-term antiepileptic therapy on the hypothalamic-pituitary axis in man

M. Franceschi, L. Perego, F. Cavagnini, A. G. Cattaneo, C. Invitti, F. Caviezel, L. F. Strambi, S. Smirne

Research output: Contribution to journalArticlepeer-review

Abstract

Effects of long-term antiepileptic therapy on the hypothalamic-pituitary axis were evaluated from the basal and stimulated plasma levels of growth hormone (GH) and prolactin (PRL) and from circadian adrenocorticotropic hormone (ACTH)/cortisol rhythms. Data for patients with well-controlled epilepsy of mild-to-moderate severity were compared with those for normal healthy volunteers. Analysis of the effects of each antiepileptic drug (AED) and of combined AEDs revealed minor abnormalities of stimulated GH secretion in all treated patients. In epileptic men, all individual AEDs (except valproate) and AED polytherapy increased both basal and stimulated plasma levels of PRL. In epileptic women, this effect was more variable and less marked, probably because of early depletion of PRL reserves. Each AED and combined AEDs did not significantly change circadian ACTH/cortisol rhythms in epileptic patients. The effects observed seem not to be related to epilepsy per se. Clinical implications, pathways, and neurotransmitters involved and possible mechanisms of the neuroendocrine effects of long-term AED therapy are discussed.

Original languageEnglish
Pages (from-to)46-52
Number of pages7
JournalEpilepsia
Volume25
Issue number1
Publication statusPublished - 1984

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

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