Abstracts

Rationale: Sexual dysfunction is common among both men and women with epilepsy. This may, at least in part, be due to the use of antiepileptic drugs (AEDs). Enzyme-inducing AEDs like carbamazepine (CBZ) reduces free fractions of peripheral sex steroid hormones, which could lead to sexual problems. Lamotrigine (LTG) has never been found to have any endocrine side effects. Levetiracetam (LEV) is a relatively new AED and may represent an alternative to the old drugs. The aim of this study is to investigate sexual function in persons with epilepsy using LTG, CBZ or LEV compared to a matched control group.Methods: Patients and Methods: Sixty-four patients (45 males/19 females) between 18 and 45 years from Norway which have used CBZ, LTG, or LEV in monotherapy for a minimum of six months were included. The control group consisted of 14 males and 12 females. Mean age in the patients was 33.4 years and in the controls 29.0 years. 36 patients were on CBZ (26 men, 10 women), 4 on LEV (3 men, 1 woman), 24 on LTG (16 men, 8 women). Sexual function is monitored by using the Arizona Sexual Experience Scale (ASEX). This is a test with 6 questions regarding sexual interest, arousal, potency, lubrication, etc. The participants give a graded answer from 1 to 6, where 1 is the best, while 6 represents major problems. The lowest possible score is then 6 (highly satisfied with sexual life) and the highest possible score is 36 (no sexual drive at all). Results: Mean total ASEX score was equal in the patient group and in the controls (12.3 and 12.2, respectively). ASEX scores for men were 11.1 in patients and 10.3 and controls, in females the scores were 14.8 and 14.3 respectively in patients and controls. The ASEX scores showed a significantly higher score when all female patients were compared to all male patients (p< 0.001). The ASEX score for individual drugs was in men: CBZ 11.4 (SD 3.3), LTG 10.5 (SD 2.2), controls 10.3 (SD 2.5); in the females using CBZ: 16.7 (SD 6.1), LTG 12.9 (SD 2.6) and in female controls 14.3 (SD 4.2). The LEV group was too small for sub-analyses. Although the differences were not statistically significant, there was a trend towards higher ASEX scores in patients on CBZ compared to LTG (for all patients: p=0.13, for men: p= 0.33 and for female patients: p=0.09).Conclusions: Women with epilepsy reports significantly more sexual difficulties than men with epilepsy. In both sexes, and most pronounced in women, patients taking CBZ reported more sexual difficulties than patients taking LTG. The findings so far may support the idea that the type of antiepileptic drug is of importance for sexual function in both men and women. The study is funded by GlaxoSmithKline.