Drug-Induced Sexual Dysfunction in Individuals with Epilepsy: Beyond Antiepileptic Compounds

Calabrò, Rocco Salvatore; Cerasa, Antonio

doi:10.3390/medicines9030023

Medicines

2022

DOI: 10.3390/medicines9030023

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Drug-Induced Sexual Dysfunction in Individuals with Epilepsy: Beyond Antiepileptic Compounds

Rocco Salvatore Calabrò

Antonio Cerasa

Abstract: Sexual dysfunction (SD) is a multifactorial problem, involving neurological, iatrogenic, endocrine, psychiatric, and psychosocial factors, and affects the quality of life of both male and female individuals with epilepsy [...]

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Cited by 3 publications

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Perampanel-induced erectile dysfunction

Dixit,

Kumar,

Trivedi

et al. 2023

Neurol Sci

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Perampanel-induced erectile dysfunction

Dixit,

Kumar,

Trivedi

et al. 2023

Neurol Sci

View full text Add to dashboard Cite

Prevalence and forms of sexual dysfunctions in Egyptian men with epilepsy in Helwan

Abou Elmaaty,

El Sherifi,

Elserafy

et al. 2023

Egypt J Neurol Psychiatry Neurosurg

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Background Although there is a striking impact of epilepsy on sexual functions, this issue is avoided by the patients, because they consider it as a taboo that brings much shame to the complainer and also largely ignored by physicians and neurologists who involved in epileptic patient management. Our aim was to investigate the prevalence and forms of sexual dysfunction (SD) in Egyptian men with epilepsy and relating this dysfunction to the type of epilepsy and the existing sex hormone disturbance. Methods We recruited seventy male epileptic patients on anti-seizure medications and seventy healthy males aged-matched control subjects. We assessed their sexual functions using IIEF-15. Results The prevalence of SD in epileptic patients in our study was as follows: erectile function (64.3%), sexual desire (45.7%), intercourse satisfaction (37.2%) and orgasmic function (15.7%). We found statistically significant lower IIEF scores in uncontrolled versus controlled epileptic patients, in spite that total and free testosterone were not statistically significantly different between the two groups. Although a lower IIEF score in focal versus generalized epilepsy was noticed, but only orgasmic function achieved statistical significance (P = 0.049). Our results exhibited no statistically significant difference as regard treatment therapy in relation to sexual function and hormonal plasma level. Conclusions A higher prevalence of sexual dysfunction was observed in the epileptic patients especially in those with uncontrolled seizures. For that reason, the issues related to sexual activity should be clarified by physicians how are involved in managing the patients suffering from epilepsy.

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Cutting the First Turf to Heal Post-SSRI Sexual Dysfunction: A Male Retrospective Cohort Study

et al. 2022

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Post-SSRI sexual dysfunction (PSSD) is a set of heterogeneous sexual problems, which may arise during the administration of selective serotonin reuptake inhibitors (SSRIs) and persist after their discontinuation. PSSD is a rare clinical entity, and it is commonly associated with non-sexual concerns, including emotional and cognitive problems and poor quality of life. To date, however, no effective treatment is available. The aim of this study was to retrospectively evaluate the potential efficacy of the different treatments used in clinical practice in improving male PSSD. Of the 30 patients referred to our neurobehavioral outpatient clinic from January 2020 to December 2021, 13 Caucasian male patients (mean age 29.53 ± 4.57 years), previously treated with SSRIs, were included in the study. Patients with major depressive disorder and/or psychotic symptoms were excluded a priori to avoid overlapping symptomatology, and potentially reduce the misdiagnosis rate. To treat PSSD, we decided to use drugs positively affecting the brain dopamine/serotonin ratio, such as bupropion and vortioxetine, as well as other compounds. This latter drug is known not to cause or reverse iatrogenic SD. Most patients, after treatment with vortioxetine and/or nutraceuticals, reported a significant improvement in all International Index of Erectile Function-(IIEF-5) domains (p < 0.05) from baseline (T0) to 12-month follow-up (T1). Moreover, the only patient treated with pelvic muscle vibration reached very positive results. Although our data come from a retrospective open-label study with a small sample size, drugs positively modulating the central nervous system serotonin/dopamine ratio, such as vortioxetine, could be used to potentially improve PSSD. Large-sample prospective cohort studies and randomized clinical trials are needed to investigate the real prevalence of this clinical entity and confirm such a promising approach to a potentially debilitating illness.

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Drug-Induced Sexual Dysfunction in Individuals with Epilepsy: Beyond Antiepileptic Compounds

Abstract: Sexual dysfunction (SD) is a multifactorial problem, involving neurological, iatrogenic, endocrine, psychiatric, and psychosocial factors, and affects the quality of life of both male and female individuals with epilepsy [...]

Cited by 3 publications

References 22 publications

Perampanel-induced erectile dysfunction

Perampanel-induced erectile dysfunction

Prevalence and forms of sexual dysfunctions in Egyptian men with epilepsy in Helwan

Cutting the First Turf to Heal Post-SSRI Sexual Dysfunction: A Male Retrospective Cohort Study

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