DIFFERENTIAL ANTIEPILEPTIC DRUG EFFECTS ON SEXUAL FUNCTION AND REPRODUCTIVE HORMONES: A COMPARISON BETWEEN LAMOTRIGINE AND ENZYME-INDUCING ANTIEPILEPTIC DRUGS
Abstract number :
1.303
Submission category :
Year :
2003
Submission ID :
2074
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
Andrew G. Herzog, Frank W. Drislane, Donald L. Schomer, Page B. Pennell, Kevin M. Kelly, Edward B. Bromfield, Erin L. Farina, Cheryl A. Frye Neurology, Beth Israel Deaconess Medical Center, Boston, MA; Psychology, University at Albany, Albany, NY; Neurolo
Sexual dysfunction is common in men with epilepsy and has been related to lower serum bioactive testosterone (BAT) levels. Enzyme-inducing antiepileptic drugs (EIAEDs) are thought to play a role. Little is known, however, about the effects of non EIAEDs. This investigation compared sexual function and gonadal steroid levels among men with localization related epilepsy (LRE) who take lamotrigine (LTG), EIAEDs, no AEDs, and normal controls.
63 men with LRE (EIAEDs n=36, LTG n=18, no AEDs n=9) and 18 normal controls, between 18-50 years of age, had blood samples assayed for LH, FSH, PRL, BAT, bioactive estradiol (BAE), sex hormone binding globulin (SHBG), BAT/BAE, and gonadal efficiency (BAT/LH). Sexual interest and function were assessed by standardized questionnaire (S-score).
S-scores, BAT, BAT/BAE and BAT/LH were significantly lower and SHBG was significantly higher in the EIAED group than in any other group (Table). There were no significant differences in these measures between men on LTG and controls or untreated men with LRE.
S-scores fell below the control range in 15 of 63 (23.8%) men with LRE, including 12 of 36 (33.3%) on EIAEDs, 1 of 18 (5.5%) on LTG and 2 of 9 (22.2%) on no AEDs ([Chi]2: p [lt] .01). BAT was below the control range ([lt]196 ng/dl) in 6 of 18 (33.3%) on LTG as compared to 20 of 36 (55.6%) on EIAEDs and 3 of 9 (33.3%) on no AEDs ([Chi]2: p [lt] .05). Among men with low S-scores, 13 of 15 (86.7%) had BAT levels below the control range. BAT levels showed a significant correlation with S-scores among the EIAED group only. There was no significant relationship with LRE duration or seizure frequency.
The rate of BAT decline with age was greater among men with LRE than controls (3.75 vs 1.80 ng/dl/yr). The slope showed no significant difference among LRE groups. By 40-50 years, however, 89% of the EIAED group had low BAT as compared to only 33% of the men on LTG and 33% on no AED.
In men with LRE, sexual function, BAT, BAT/BAE and gonadal efficiency (BAT/LH) are higher with the use of LTG than EIAEDs.[table1]
[Supported by: GlaxoSmithKline]