Differential Effects of Antiepileptic Drugs on Sexual Function and Reproductive Hormones in Men with Epilepsy: Interim Analysis of a Comparison between Lamotrigine and Enzyme‐inducing Antiepileptic Drugs

Abstract

Summary: Purpose:We compared sexual function and reproductive hormone levels among men with localization-related epilepsy (LRE) taking various antiepileptic drugs (AEDs) and normal controls (NC).Methods: Subjects were 63 men with LRE [enzyme-inducing (EI) AEDs, 36; lamotrigine (LTG), 18; no AEDs, 9] and 18 NC. Sexual interest and function (S-score), hormone levels [bioactive testosterone (BAT) and estradiol (BAE)], hormone ratios [BAT/BAE], and gonadal efficiency [BAT/luteinizing hormone (LH)] were compared among the groups.Results: S-scores, BAT levels, BAT/BAE, and BAT/LH were significantly lower in the EIAED group than in NC or LTG groups. Sex hormone-binding globulin (SHBG) was significantly higher in the EIAED group than in all other groups. Of men with LRE, 23.8% had abnormally low S-scores: 33.3% taking EIAEDs, 5.5% taking LTG, and 22.2% taking no AEDs (p < 0.01). BAT was low in 55.6% taking EIAEDs as compared with 33.3% taking LTG and 33.3% taking no AEDs (p < 0.05). Among men with low S-scores, 86.7% had low BAT as compared with 33.3% of men with normal scores (p < 0.01). BAT decline with age was greater among men with LRE than in controls (3.75 vs. 1.80 ng/dl/yr). The slope showed no significant difference among LRE groups. However, 89% of 40-to 50-year-old men taking EIAEDs had low BAT as compared with 33% taking LTG and 33% taking no AED (p < 0.01).Conclusions: Sexual function, BAT levels, BAT/BAE, and gonadal efficiency are greater with LTG than with EIAED. Abnormally low BAT levels are reached at an earlier age with EIAEDs than with LTG.

Effects of valproate and carbamazepine monotherapy on neuroactive steroids, their precursors and metabolites in adult men with epilepsy

“…Some of these effects, however, appear to be reversible [38]. CBZ therapy suppresses sperm concentration, reduces the motility of sperm [39], and negatively correlates with the sexual function score as reported by Herzog et al [40]. Their more recent study, however, did not confirm this relationship [41].…”

Antioxidant Capacity of Momordica charantia Extract and its Protective Effect on Testicular Damage in Valproic Acid-Induced Rats

“…In addition, VPA can cause fibrosarcomas and adenocarcinomas in the uterus (Watkins et al, 1992;Jentink et al, 2010;Witczak et al, 2010). Indeed, it has been reported to have adverse effects such as decreasing of sex hormones and sperm qualities (Nishimura et al, 2000;Herzog et al, 2004;Hamza & Amin, 2007;Khan et al, 2011;Iamsaard et al, 2017a,b;Sukhorum & Iamsaard, 2017). Currently, herbal medicines have been studied for searching of alternative VPA treatments (Sakr et al, 2014;Iamsaard et al, 2015Iamsaard et al, , 2017bSukhorum et al, 2016).…”

Protective Effect of Momordica cochinchinensis (L.) Spreng Aril Extract on Essential Testicular Markers in Rats Induced with Valproic Acid

“…This receptor signaling is important for the steps of spermatogenesis to maintain sperm production (O'Hara & Smith, 2015). Additionally, VPA was shown to reduce testosterone levels (Bauer et al, 2004;Herzog et al, 2004;Sukhorum et al, 2017) but actual mechanism of that effect was still unexplained. To clarify that issue, this study demonstrated that the low expression of testicular StAR and AR proteins in VPA-treated rat as compared with control.…”