PCOS Messages for December, 2002: Re: question about anticonvulsants such as Depakote and PCOS (also new to this list) and metformin alternatives

Re: question about anticonvulsants such as Depakote and PCOS (also new to this list) and metformin alternatives

From: Eileen (anonymous@obgyn.net)
Sun, 29 Dec 2002 00:33:59 -0600 (CST)

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At Wed, 30 Jan 2002, Belle wrote: >
>I do not understand why you are so upset with your doctor who prescribed
>the Depakote and not the one who prescribed the BCP. The pill also
>decreases glucose metabolism which causes us to have increased insulin
>in order to take care of the glucose. :-)
>
>Drug information can be found in a number of sources. You could look up
>information on drugs on the net. Nearly all drugs have prescribing
>information from the manufacturer, PDR, or other drug sites. There are
>also drug books sold in stores that can be of benefit when you are
>attempting to decide if a drug is good for you. You should also feel
>free to ask your doctor if there are any interactions with any of your
>other prescribed medications or OTC drugs. Your doctor should also know
>if the drug s/he is prescribing has the potential to cause problems in
>people who are glucose intolerant.
>
>Avandia may work for you but weight gain is a possible side effect to
>it. There have not been any studies that I am aware of that have
>Avandia tested against Glucophage to determine efficacy. Many women
>take the two drugs together. If you are having side effects from the
>Glucophage and you have not been on it for a long time, you may want to
>decrease your dosage until your body becomes accustomed to the
>Glucophage. Increase the dosage by 1/2 or 1/4 of a pill every week
>until you reach your prescribed dosage.
>
>>A couple of years ago a doc put me on Depakote to see if I was bi-polar
>>or not and i came across a med article stating that under no
>>circumstances should a PCOS woman take it as it makes symptoms far worse
>>and can make one even more hyperinsulinemic. I was pretty angry with
>>the doc but I guess as a psychiatrist he wouldn't know anything about
>>PCOS.
>>
>>Since that time I was involved in a study of women with PCOS at Stanford
>>in which i underwent a complicated test that proved that I am indeed
>>very insulin resistant, have low "good" cholesterol, high bad
>>cholesterol, etc. and am officially pre-diabetic. (I mention this
>>because I was reading a message on this board last night that mentioned
>>that probably no one on this board has had such a test since they are
>>only done in clinical trials. I've had one, and believe me, having your
>>pancreas temporarily shut down ain't a whole lot of fun.)
>>
>>I'm not too concerned with my hairy chin (I shave but if I could I'd
>>grow it just to see what it was like) and the acne is controlled with
>>BCP (tho I wish I could wear contacts again and I suspect the pill is
>>the problem there), but I am gaining weight like crazy again and that
>>really concerns me.
>>
>>The doctor has prescribed Topamax (generic topiramate) on top of my
>>usual smorgasbord of antidepressants and I am wondering if any of you
>>have heard if any other drugs besides Depakote are no no's for women
>>with PCOS? The logic being that if one anticonvulsant is bad, would
>>others be???
>>
>>Also are there any alternatives to metformin that are as effective
>>(avandia?) because I have vicious side effects to the metformin.
>>--
>>Julie
>>
>--
>Hope this helps,
>
>Belle
>

-- Belle, I have checked the information included with the medication (Depakote) as well as books on medication. No where in this literature does it tell the patient that one of the risks of Depakote is developing PCOS. I have learned only recently (from my cousin) about the link after she herself was told by her new Neurologist. She developed this syndrome and it was misdiagnosed for over 5 years of so. As a result she is now infertile, overweight and has increased her risk for diabetes as well as ovarian and uterian cancers among other health risks. Her doctor continued her on the Depakote even after she was diagnosed with PCOS.

The reason I am so interested in this at this time is because my 11 year old daughter was diagnosed with epilepsy 2 1/2 years ago and was prescribed Depakote. I have already "fired" her previous Neurologist and have appointments set up with a new Neurologist at the earliest time they had... February, 2003. In the meantime, her Pediatrician is just as concerned as I am about her developing PCOS that we are currently reducing her dose (slowly of course) to start the process of getting her off this medication. It angers me that her Neurologist even prescribed it to her given the fact that a study was released in the November 4, 1993 issue of the New England Journal of Medicine regarding the high percentage of Depakote patients developing PCOS. Taking Depakote with a diagnosis of PCOS increases the risks greatly of developing these cancers and other major health issues. I don't blame Julie at all for being angry with the doctor. Correct me if I'm wrong, but I feel it is the Physicians JOB to read and know everything they can about the medications they prescribe!

I am very angry with the doctor that prescribed this to my daughter and I think I have every right to be angry. After calling her office regarding the information on Depakote, I have not received so much as a phone call from her. I feel that since the study results were released in 1993 (and several others since that time), by 2000 she should have read them and changed her practice of prescribing this medication to female patients. Now I'm concerned whether my daughter will ever start her period. Unfortunately she has been on Depakote since she was 9. One of the first signs of PCOS is missed cycles, since she hasn't started yet we may not know for a few years whether she has developed PCOS or not. All we can do is get her off the medication and hope for the best.

I hope this information helps other users of Depakote, whether they have been diagnosed with PCOS yet or not. There is reason to be alarmed and anyone taking this medication should consult their physician immediately regardless if you are experiencing symptoms of PCOS or not.

To answer your question Julie, other anti-convulsant meds have been mentioned in conjunction with PCOS but Depakote is the worst. Try searching the web for "PCOS Depakote", the studies will turn up in the results and it will give you the percentage risks for the other anti-convulsants. Good luck!

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