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One death occurred on progesterone, which was attributed to sudden unexplained death in epilepsy. A post hoc analysis of the same RCT showed that the pattern of perimenstrual seizure exacerbation (C1) was a significant predictor of ≥50% reduction in all seizures in patients receiving progesterone vs patients receiving placebo.
Both estradiol and progesterone/allopregnanolone may have beneficial effects for patients with epilepsy. Individualized hormonal therapy should be considered as adjunctive treatment in patients with epilepsy to improve seizure control as well as quality of life.
Natural progesterone can reduce the frequency of seizures. To date, there have been 5 important studies using natural progesterone as a treatment. Natural progesterone is sold in compound pharmacies in lozenge, suppository, lotion, and pill form (Prometrium).
This review highlights a significant deficiency within the evidence base for clinical studies of treatments used in catamenial epilepsy. The included RCTs provided very limited data on the effectiveness of norethisterone and progesterone in catamenial epilepsy with regular menses.
Objective: Catamenial epilepsy (CE) is defined as an increase in seizure frequency during specific phases of the menstrual cycle in women with epilepsy. The treatment usually includes a combination of non-hormonal and hormonal therapies.
Current treatment of catamenial epilepsy depends on whether a woman has regular or irregular menstrual periods. If a woman has regular periods, hormonal (e.g. progesterone supplements) and non-hormonal treatments (e.g. clobazam or acetazolamide) taken prior to and during a period may be used.
Background: Progesterone with its anti-seizure effect plays a role in the pathophysiology of catamenial epilepsy which affects 31-60% of epileptic women. In this study, an attempt to treat women suffering from catamenial epilepsy with progesterone, as an adjuvant drug, was made.
