The informed scientist

Hormonal treatment for women with epilepsy can be a useful addition to antiepileptic drugs in the effort to decrease seizures. Although there is a paucity of hard evidence based studies concerning hormonal treatment in catamenial or non-catamenial epilepsy, experience and case reports have been published. Currently there is an ongoing double-blind, placebo controlled study of hormonal treatment for women. The hormone is progesterone and is often given as an injection every third month to cause amenorrhea (Medroxiprogesteron, Depo-Provera). The place of hormonal treatment for epilepsy would be as an addition to AEDs, not as a substitute. One area where hormonal therapy has a practical function is inducing amenorrhea in severely functionally handicapped women to avoid menstruation and also improve seizure control. For other women with refractory epilepsy hormonal control can improve seizure severity or reduce seizures and we await more specific information from the ongoing RCT.