Polycystic ovary syndrome and the new antiepileptic drugs: A systematic review

Objective
To evaluate the presence of polycystic ovary syndrome (PCOS) in women of reproductive age with the use of antiepileptic drugs.

Methods
A systematic literature review of observational analytical studies (cohort, cross-sectional and case-control), from January 1966 to January 2021 on PCOS in women of reproductive age with the use of the antiepileptics. The search covered the Cochrane, MEDLINE, Embase and LILACS databases. Inclusion criteria: Studies reporting the frequency of PCOS with the antiepileptic drugs in women of reproductive age. Exclusion criteria: studies that did not have categorically relevant measurements, those published as abstracts only, and studies of investigational treatment. Data extraction was performed based on the PECOT strategy, considering the method of intervention, methodological quality, and presence of PCOS with the antiepileptic drugs.

Results
A total of 2043 references were obtained from which 22 articles were selected by title and abstract. Four articles met the inclusion criteria. No articles were found describing the risk of PCOS upon exposure to levetiracetam, felbamate, gabapentin, lacosamide, pregabalin, rufinamide, tiagabine, topiramate, vigabatrin, or zonisamide. Only articles related to oxcarbazepine and lamotrigine were found, in which the frequency of PCOS was like that found in women without epilepsy.

Conclusions
The anticonvulsants are probably safer, but the risk of developing PCOS associated with the antiepileptics cannot be established, since there are insufficient studies.