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It has previously been reported that sodium valproate (Epilim) lowers plasma ACTH levels in Nelson's syndrome. This report describes further experience with its use. Ten patients with Nelson's syndrome were treated with sodium valproate (600-1200 mg/day) for 5-32 weeks. Plasma ACTH was measured by cytochemical methods and RIA. Initial treatment for 5-12 weeks significantly (P less than 0.005) lowered plasma ACTH from a pretreatment mean of 2460 +/- 1870 ng/liter to 480 +/- 330 ng/liter, and the ACTH circadian rhythm was restored in two patients. On discontinuing treatment, plasma ACTH levels remained suppressed for 3 weeks and rose to pretreatment values in 5-12 weeks. Two patients' plasma ACTH levels failed to show a second response to treatment, while a third patient had a favorable second response to treatment over 32 weeks. In six patients, skin pigmentation lightened with treatment, and in one patient, a reduction in size of a pituitary microadenoma, demonstrated radiographically, occurred with treatment. gamma-Aminobutyric acid and sodium valproate were shown to be ineffective in inhibiting ACTH secretion from cultured pituitary tumor cells from a patient with Nelson's syndrome. The results show that sodium valproate is effective in some cases of Nelson's syndrome. We suggest that it reduces the hypersecretion of ACTH by enhancing gamma-aminobutyric acid function in the hypothalamus, thereby inhibiting the release of corticotropin-releasing factor.
A Dornhorst, and
J S Jenkins, and
S W Lamberts, and
R R Abraham, and
V Wynn, and
U Beckford, and
B Gillham, and
M T Jones
August 1981,
Lancet (London, England),
A Dornhorst, and
J S Jenkins, and
S W Lamberts, and
R R Abraham, and
V Wynn, and
U Beckford, and
B Gillham, and
M T Jones
February 1988,
Clinical endocrinology,
A Dornhorst, and
J S Jenkins, and
S W Lamberts, and
R R Abraham, and
V Wynn, and
U Beckford, and
B Gillham, and
M T Jones
May 1981,
Lancet (London, England),
A Dornhorst, and
J S Jenkins, and
S W Lamberts, and
R R Abraham, and
V Wynn, and
U Beckford, and
B Gillham, and
M T Jones
August 1988,
Klinische Wochenschrift,
A Dornhorst, and
J S Jenkins, and
S W Lamberts, and
R R Abraham, and
V Wynn, and
U Beckford, and
B Gillham, and
M T Jones
January 1988,
Endokrynologia Polska,
A Dornhorst, and
J S Jenkins, and
S W Lamberts, and
R R Abraham, and
V Wynn, and
U Beckford, and
B Gillham, and
M T Jones
January 1989,
Acta medica Polona,
A Dornhorst, and
J S Jenkins, and
S W Lamberts, and
R R Abraham, and
V Wynn, and
U Beckford, and
B Gillham, and
M T Jones
November 1988,
Acta endocrinologica,
A Dornhorst, and
J S Jenkins, and
S W Lamberts, and
R R Abraham, and
V Wynn, and
U Beckford, and
B Gillham, and
M T Jones
September 1980,
The Australian and New Zealand journal of psychiatry,
A Dornhorst, and
J S Jenkins, and
S W Lamberts, and
R R Abraham, and
V Wynn, and
U Beckford, and
B Gillham, and
M T Jones
January 1979,
Endokrynologia Polska,
A Dornhorst, and
J S Jenkins, and
S W Lamberts, and
R R Abraham, and
V Wynn, and
U Beckford, and
B Gillham, and
M T Jones
January 1982,
Acta neurochirurgica,
