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Seizure exacerbation associated with inhibition of progesterone metabolism

Authors

  • Andrew G. Herzog MD, MSc,

    Corresponding author
    1. Harvard Neuroendocrine Unit, Beth Israel Deaconess Medical Center, Boston, MA
    • Harvard Neuroendocrine Unit, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215
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  • Cheryl A. Frye PhD

    1. Department of Psychology, University of Albany–SUNY, Albany, NY
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Abstract

The reduced progesterone metabolite tetrahydroprogesterone is a potent positive modulator of GABAA chloride conductance that exerts powerful neuroinhibitiory and antiseizure effects in animal models. Cyclic natural progesterone use may lessen seizure frequency in women with catamenial seizure exacerbation. We report a case in which efficacy was eliminated during concomitant treatment with a reductase inhibitor. The observation suggests that a reduced metabolite, rather than progesterone itself, was responsible for improved seizure control. Ann Neurol 2003;53:390–391

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