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Neuroendocrine Section, Neurological Unit, Charles A. Dana Research Institute, Beth Israel Hospital, and the Department of Neurology, Harvard Medical School, Boston. MA.
We studied eight women who had complex partial seizures and anovulatory cycles or inadequate luteal phases. Progesterone suppositories were given during the premenstrual phase or entire second half of the cycle in doses of 50 to 400 mg q12h. Antiseizure medication levels were kept in the therapeutic range. Average monthly seizure frequency declined by 68% (p < 0.05, Wilcoxon matched-pairs test) in a 3-month treatment period compared with the 3 months prior to therapy, and six of the eight women had fewer seizures. None experienced more seizures or disruption of menses. Transient tiredness and depression were noted in some when progesterone dosage was raised above minimally effective levels. These symptoms cleared within 48 hours of lowering the dosage. The value of intermittent natural progesterone therapy as a safe, well-tolerated, and effective adjunct to antiseizure therapy should be assessed further.
Address correspondence and reprint requests to Dr. Herzog. Neurological Unit. Beth Israel Hospital, 330 Brookline Avenue, Boston, MA 02215.
Supported in part by the Sheila Wright Benjamin Memorial Fund.
Presented in part at the thirty-eighth annual meeting of the American Academy of Neurology, New Orleans, LA, April 1986.
Accepted for publication April 9, 1986.
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