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Progesterone therapy in women with complex partial and secondary generalized seizures
Abstract
This open trial assessed the effects of adjunctive progesterone therapy on seizure frequency in 25 women with catamenial exacerbation of complex partial (CPS) and secondary generalized motor (SGMS) seizures. Progesterone was well tolerated by 23 of the 25 women and had readily reversible dose-related side effects of asthenia and emotional depression in two. Eighteen women (72%) experienced a decline in seizure frequency during a 3-month treatment period compared with the 3 months prior to therapy (p < 0.01). Average daily CPS frequency declined by 54% (p < 0.01), SGMS by 58% (p < 0.02).
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“while clinical trials have also been conducted with progesterone, the synthetic progestin norethisterone, and the gonadotropin antagonist goserelin [54,147].”
From Fibromyalgia pathogenesis explained by a neuroendocrine multistable model (2024) · cites this paper as [54]
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Diagnosis and management of catamenial seizures: a review
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“42,43 Seizures decrease in the mid-luteal phase when serum progesterone levels are high, and increase premenstru-ally when there is a fall in progesterone levels and serum progesterone/estrogen ratio.”
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Self-citationManaging Epilepsy in Women of Childbearing Age
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“In women with catamenial epilepsy, progesterone produced a decrease in seizure frequency([16]) but norethisterone failed to show any antiepileptic benefit.”
Hormones and Cognition: Current Concepts and Issues in Neuropsychology
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Hormonal Therapies: Progesterone
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“[102] administered progesterone lozenges, 200 mg three times daily, on Days 23 to 25 of each menstrual cycle to women with perimenstrual seizure exacerbation, and on Days 15 to 25 of each menstrual cycle to women with luteal phase seizure exacerbation.”
BackgroundMethodVariation of Seizure Frequency with Ovulatory Status of Menstrual Cycles
Herzog, A. G., Fowler, K. M., Sperling, M. R., Liporace, J., Kalayjian, L., Heck, C., Krauss, G., Dworetzky, B. A., & Pennell, P. (2011) · Epilepsia · doi:10.1111/j.1528-1167.2011.03194.x · Cited by 39
“…Philadelphia, Pennsylvania, U.S.A.; zKeck School of Medicine, University of Southern California, Los Angeles, California, U.S.A.; xDepartment of Neurology, University of Maryland, Baltimore, Maryland, U.S.A.; and{Department of Neurology, Brigham and Women’s Hospital, Boston, Massachusetts, U.S.A.”
BackgroundSelf-citationMass spectrometric assay and physiological-pharmacological activity of androgenic neurosteroids.
Reddy, D. (2008) · Neurochemistry International · doi:10.1016/j.neuint.2007.05.019 · Cited by 38
“…shown to play a significant role in the pathophysiology of brain disorders such as generalized anxiety disorder, depression, epilepsy and stress (Herzog, 1995; Reddy et al., 2001; Smith et al., 1998; Monteleone et al., 2000; Purdy et al., 1991; Reddy and Rogawski, 2002; Dong et al., 2001; Reddy…”
BackgroundTheophylline increases “on” time in advanced parkinsonian patients
Kostić, V., Svetel, M., Šternić, N., Dragašević, N., & Przedborski, S. (1999) · Neurology · doi:10.1212/wnl.52.9.1916 · Cited by 38
The Effects of Epilepsy and Its Treatment on Sexual and Reproductive Function
Penovich, P. E. (2000) · Epilepsia · doi:10.1111/j.1528-1157.2000.tb01524.x · Cited by 37
Chapter 3 Hormonal Influences on Seizures
Frye, C. (2008) · International review of neurobiology · doi:10.1016/s0074-7742(08)00003-2 · Cited by 35
Tominaga, K., Yamauchi, A., Shuto, H., Niizeki, M., Makino, K., Oishi, R., & Kataoka, Y. (2001) · European Journal of Pharmacology · doi:10.1016/s0014-2999(01)01377-2 · Cited by 34
Pharmacotherapeutic Issues for Women of Childbearing Age with Epilepsy
Chang, S.-I., & McAuley, J. (1998) · The Annals of Pharmacotherapy · doi:10.1345/aph.17253 · Cited by 34
2005 AES Annual Course: Evidence Used to Treat Women with Epilepsy
Pennell, P. (2006) · Epilepsia · doi:10.1111/j.1528-1167.2006.00660.x · Cited by 33
“Open-label studies of progesterone supplementation have shown promising results (4,5).”
BackgroundReddy, D. S., & Ramanathan, G. (2012) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2012.05.024 · Cited by 37
Special Considerations for Women with Epilepsy
Yerby, M. (2000) · Pharmacotherapy · doi:10.1592/phco.20.12.159s.35249 · Cited by 31
“A natural progesterone lozenge is available; 100–200 mg 3–4 times/day, with target progesterone levels of 5–25 ng/ml is recommended.(31) Many women experience side effects including sedation, depression, breast tenderness, weight gain, and vaginal spotting when taking progesterone, thereby limiting its utility.”
BackgroundNeuroactive steroids in neuropsychopharmacology.
Rupprecht, R., & Holsboer, F. (2001) · International review of neurobiology · doi:10.1016/s0074-7742(01)46072-7 · Cited by 31
Pack, A. M. (2010) · Epilepsia · doi:10.1111/j.1528-1167.2010.02631.x · Cited by 30
“Two open-label trials of 200 mg natural progesterone lozenges also found significant improvement in seizure frequency (>50% reduction) (Herzog, 1995, 1999).”
BackgroundInfluence of sex hormones on brain excitability and epilepsy
Verrotti, A., Latini, G., Manco, R., Simone, M. D., & Chiarelli, F. (2007) · Journal of Endocrinological Investigation · doi:10.1007/bf03350821 · Cited by 29
Infusion of 3α,5α-THP to the pontine reticular formation attenuates PTZ-induced seizures☆
Frye, C., Manjarrez, J., & Camacho-Arroyo, I. (2000) · doi:10.1016/s0006-8993(00)02897-3 · Cited by 30
Pharmacotherapy of catamenial epilepsy
Reddy, D. (2005) · Indian Journal of Pharmacology · doi:10.4103/0253-7613.16851 · Cited by 29
“Average monthly seizure frequency was reportedly reduced by 54% to 68% during the 3 month treatment period.([31]) A 3 year follow-up report finds that 15 of the women continued on”
Background
Metadata
- Authors
- Herzog, A. G.
- Affiliations
- Beth Israel Deaconess Medical Center (US)
- Corresponding author
- Herzog, Andrew G.
- ORCID
- Herzog, Andrew G.
- Venue
- Neurology
- Published
- 1995-09
- Volume
- 45
- Issue
- 9
- Pages
- 1660-1662
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W2011191676
- Cited by
- 218
- References
- 0
- Citations by year
- 2025: 3 · 2024: 2 · 2023: 4 · 2022: 2 · 2021: 4 · 2020: 7 · 2019: 1 · 2018: 4 · 2017: 3 · 2016: 3 · 2015: 3 · 2014: 6 · 2013: 15 · 2012: 9
- FWCI
- 4.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Epilepsy research and treatment
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmacological Effects and Toxicity Studies
- Health Sciences › Medicine › Physiology (medical) › Diet and metabolism studies
- Keywords
- progesterone therapy, adjunctive therapy, complex partial seizures, seizure frequency, women, menstrual cycle, adverse drug reactions
- MeSH terms
- Adolescent, Adult, Epilepsy, Generalized, Female, Humans, Progesterone, Epilepsy, Complex Partial
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