Background: Women with epilepsy (WWE) tend to have hormonal and metabolic abnormalities, raising concerns about an increased risk of cardiovascular or cerebrovascular disorders. Objective: This study was performed to determine whether specific epilepsy syndrome itself and/or specific antiepileptic drug (AED) medication causes altered insulin sensitivity. Methods: Fifty three WWE (12- 46) years old, currently on AED therapy [carbamazepine (CBZ) or valproate (VPA) or both] for one month or more, were recruited for this study. Serum levels for fasting insulin and glucose were tested. Homeostasis model assessment (HOMA)-index and the quick insulin sensitivity check index (QUICKI) were used as markers for insulin resistance. Results: Of the 53 total patients, 16 women were diagnosed with primary generalized epilepsy (PGE) and the other 37 were diagnosed with localization-related epilepsy (LRE). Among the subjects, 30 women were on CBZ, 9 were on VPA and 14 were on both drugs. Significantly impaired insulin sensitivity was detected in patients on combined VPA and CBZ therapy compared with patients on monotherapy with either of them. There were no differences in fasting insulin, glucose and insulin sensitivity, between PGE and LRE groups. Conclusions: WWE on combined VPA and CBZ therapy more frequently suffer from hyperinsulinemia and impaired insulin sensitivity. This combination might not be safe when prescribed to the patients with high risk of vascular disorders. [Egypt J Neurol Psychiat Neurosurg. 2011; 48(2): 199-203]
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