To describe the first reported case of a seizure in a patient using the dietary supplement DHEA in an attempt to improve ovarian oocyte production.
University-affiliated teaching hospital, neurologic department.
A 30-year-old woman with fragile X syndrome and no history of any convulsive disorder who was receiving IVF treatment.
Daily treatment with the dietary supplement DHEA.
After 1 month of DHEA treatment, the patient was admitted with a generalized seizure.
A generalized seizure, associated with concurrent intake of DHEA.
"7-keto DHEA would also have a distinct advantage over DHEA as a treatment for alcohol abuse and dependence in that it does not act as a precursor for the sex hormones (Lardy et al., 1998) and would be free of the adverse effects associated with increased production of testosterone and estradiol (Panjari and Davis, 2007). Furthermore, unlike the sulfated form of DHEA (DHEA-S) (Ticku and Kulkarni, 1988) and the negative modulator RO15-4513 (Karp et al., 2009), there is very little evidence that DHEA (Heuser et al., 1965) or 7-keto DHEA are proconvulsant unless administered in large concentrations directly into the brain. In contrast, RO15-4513 has been shown to be convulsant in rats at relatively high doses, and a study by Miczek and Weerts (1987) found that small doses of this compound (1 mg/kg) in primates produced overt seizure-related behaviors (e.g., tremors) including a fatal tonic-clonic seizure in one subject. "
[Show abstract][Hide abstract] ABSTRACT: Dehydroepiandrosterone (DHEA), 7-keto DHEA, and several comparison drugs (ethanol, chlordiazepoxide, rauwolscine, and RO15-4513) were administered to male rats responding under a multiple schedule of food and ethanol presentation to determine their selectivity for decreasing ethanol-maintained responding. DHEA and 7-keto DHEA significantly decreased both ethanol-maintained and food-maintained responding, compared with the control, while also decreasing the blood ethanol concentration (BEC). Acute ethanol administration also decreased responding for both food and ethanol; however, ethanol-maintained responding was more potently decreased than food-maintained responding. BEC remained relatively stable after increasing ethanol doses. Among the other drugs tested, RO15-4513 was the most selective for decreasing ethanol-maintained responding compared with food-maintained responding, and it decreased BECs as ethanol-maintained responding decreased. The largest dose of rauwolscine significantly decreased responding for food, whereas it did not affect ethanol-maintained responding compared with the control. Low to intermediate doses of rauwolscine produced small, nonsignificant increases in ethanol-maintained responding and BECs. Chlordiazepoxide produced significant decreases in food-maintained responding and the dose of ethanol presented, but only at the highest dose tested. Although DHEA and 7-keto DHEA did not decrease ethanol-maintained responding as selectively as ethanol or RO15-4513 under the multiple schedule, these neurosteroids may be valuable pharmacological tools in the development of new treatments for alcohol abuse and dependence.
"In over 1,000 patients supplemented with DHEA, we did not encounter a single complication of clinical significance. A recent paper from Israel reported a posttraumatic seizure after one month of DHEA supplementation in attempts to improve oocytes yields . Except for the anecdotal association, there appears no clinical significance to this report. "
[Show abstract][Hide abstract] ABSTRACT: With infertility populations in the developed world rapidly aging, treatment of diminished ovarian reserve (DOR) assumes increasing clinical importance. Dehydroepiandrosterone (DHEA) has been reported to improve pregnancy chances with DOR, and is now utilized by approximately one third of all IVF centers world-wide. Increasing DHEA utilization and publication of a first prospectively randomized trial now warrants a systematic review.
PubMed, Cochrane and Ovid Medline were searched between 1995 and 2010 under the following strategy: [ and ]. Bibliographies of relevant publications were further explored for additional relevant citations. Since only one randomized study has been published, publications, independent of evidence levels and quality assessment, were reviewed.
Current best available evidence suggests that DHEA improves ovarian function, increases pregnancy chances and, by reducing aneuploidy, lowers miscarriage rates. DHEA over time also appears to objectively improve ovarian reserve. Recent animal data support androgens in promoting preantral follicle growth and reduction in follicle atresia.
Improvement of oocyte/embryo quality with DHEA supplementation potentially suggests a new concept of ovarian aging, where ovarian environments, but not oocytes themselves, age. DHEA may, thus, represent a first agent beneficially affecting aging ovarian environments. Others can be expected to follow.
[Show abstract][Hide abstract] ABSTRACT: To present the possible positive effect of dehydroepiandrosterone administration in assisted reproduction and especially in poor responders, women with diminished ovarian reserve, premature ovarian failure and premature ovarian aging in the course of ovarian stimulation protocols followed either by intrauterine insemination or IVF.
Overall, 50-75 mg of dehydroepiandrosterone supplementation for at least 4 months may either result in natural conception or considerably improves intrauterine insemination and IVF outcome and pregnancy rates to women with confirmed diminished ovarian reserve, premature ovarian failure or premature ovarian aging. Positive effect has been reported to oocyte and embryo quality, even to women aged 40-47 years. The number of euploid embryos is increased, and miscarriage rate is decreased.
Although more data on the dehydroepiandrosterone effect on assisted reproduction are needed, results obtained over the last few years confirm the improvement of oocyte production and pregnancy rates. No significant side effects are reported, and those include mainly hirstusism and acne.
Current opinion in obstetrics & gynecology 09/2009; 21(4):306-8. DOI:10.1097/GCO.0b013e32832e0785 · 2.07 Impact Factor
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