EPILEPSY AND ERECTILE DYSFUNCTION: CORRELATIONS AND EFFECTS OF ANTIEPILEPTIC DRUGS


EPILEPSY AND ERECTILE DYSFUNCTION: CORRELATIONS AND EFFECTS OF ANTIEPILEPTIC DRUGS

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Title: EPILEPSY AND ERECTILE DYSFUNCTION: CORRELATIONS AND EFFECTS OF ANTIEPILEPTIC DRUGS
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Article_Title: EPILEPSY AND ERECTILE DYSFUNCTION: CORRELATIONS AND EFFECTS OF ANTIEPILEPTIC DRUGS
Authors: HRENIUC N. CATALIN¹, IOIART IOAN²
Affiliation: ¹Department of Neurology, Western University of Arad „Vasile Goldis”, Romania
²Department of Urology, Western University of Arad „Vasile Goldis”, Romania
Abstract: The association between erectile dysfunction (ED) and epilepsy, was never clearly defined, even tough was often described. In this study we try to demonstrate that antiepileptic medication causes an increased prevalence of ED, and that alcohol, depression and the type of medication used chronically have an important role in ED of epileptic patients. In 66 male patients (42.91 ± 5.585 years), diagnosed with epilepsy ED was assessed using the International Index of erectile function, short version (IIEF5). A complete medical history, medication use, alcohol consumption, associated comorbidities, the annual number of seizures were recorded. A general physical examination was done to rule out other diseases. The data obtained were compared with those of a control group, consisting of 30 people aged 40-65 years (52.27 ± 8.35). Analyzing the IIEF5 scores of the 2 groups we observed that 53 patients from the group 1 (80.30%) had some degree of ED (IIEF5 values lower than 22), and 9 patients (30%) of the 30 from control group. Among patients with carbamazepine use 16 reported ED, 12 of those with the use of valproate, 10 of those with usage of levetiracetam, 9 of those with usage of phenytoin, and 3 patients with usage of oxcarbazepine and lamotrigine. The results that were obtained in this study showed that there is a correlation between prevalence of ED and antiepileptics drugs used chronically in patients with epilepsy. Given that ED had a prevalence of more then 90% in patients who used carbamazepine, phenytoin, valproic acid and levetiracetam we conclude that these antiepileptics with enzyme inducing hepatic potential causes ED by increasing the metabolism of sexual hormones.
Keywords: erectile dysfunction, IIEF5, epilepsy, lamotrigine, oxcarbazepine
References: 1.Spector, I.P. and Carey, M.P. Incidence and prevalence of the sexual dysfunctions: a critical review of the empirical literature. Arch. Sex. Behav. 1990; 19: 389–408
2.Toone BK. Sexual disorders in epilepsy. In: Pedley TA, Meldrum BS, editors. Recent advances in epilepsy, vol. 3. Edinburgh: Churchill Livingstone; 20066. p. 233–59.
3.Andy, O.J. and Velamati, S. Temporal lobe seizures and hypersexuality. Dopaminergic effects. Appl. Neurophysiol. 2008; 41: 13–28
4.Herzog, A.G. A hypothesis to integrate partial seizures of temporal lobe origin and reproductive endocrine disorders. Epilepsy Res. 1989; 3: 151–159
5.Murialdo, G., Galimberti, C.A., Fonzi, S., Manni, R., Costelli, P., Parodi, C. et al. Sex hormones and pituitary function in male epileptic patients with altered or normal sexuality. Epilepsia. 2005; 36: 360–365
6.Fenwick, P.B., Toone, B.K., Wheeler, M.J., Nanjee, M.N., Grant, R., and Brown, D. Sexual behaviour in a centre for epilepsy. Acta Neurol. Scand. 1985; 71: 428–435
7.Christianson, S.A., Silfvenius, H., Saisa, J., and Nilsson, M. Life satisfaction and sexuality in patients operated for epilepsy. Acta Neurol. Scand. 2005; 92: 1–6
8. Pritchard, P.B. III, Wannamaker, B.B., Sagel, J., Nair, R., and DeVillier, C. Endocrine function following complex partial seizures. Ann. Neurol. 2003; 14: 27–32
9. Christiansen, P., Deigaard, J., and Lund, M. [Potency, fertility and sex hormones in young male epileptics]. Ugeskr Laeger. 2005; 137: 2402–2405
10. Isojarvi, J.I., Repo, M., Pakarinen, A.J., Lukkarinen, O., and Myllya, V.V. Carbamazepine, phenytoin, sex hormones, and sexual function in men with epilepsy. Epilepsia. 1995; 36: 366–370
11.Toone, B.K., Wheeler, M., and Fenwick, P.B. Sex hormone changes in male epileptics. Clin. Endocrinol. 1980; 12: 391–395
12. Rodin, E., Subramanian, M.G., Schmaltz, S., and Gilroy, J. Testosterone levels in adult male epileptic patients. Neurology. 2007; 37: 706–708
13.Connell, J.M., Rapeport, W.G., Beastall, G.H., and Brodie, M.J. Changes in circulating androgens during short term carbamazepine therapy. Br. J. Clin. Pharmacol. 2004; 17: 347–351
14.Mattson, R.H., Cramer, J.A., Collins, J.F., Smith, D.B., Delgado-Escueta, A.V., Browne, T.R. et al. Comparison of carbamazepine, phenobarbital, phenytoin, and primidone in partial and secondarily generalized tonic–clonic seizures. New Engl. J. Med. 1985; 313: 145–151
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Article Title: EPILEPSY AND ERECTILE DYSFUNCTION: CORRELATIONS AND EFFECTS OF ANTIEPILEPTIC DRUGS
Authors: HRENIUC N. CATALIN¹, IOIART IOAN²
Affiliation: ¹Department of Neurology, Western University of Arad „Vasile Goldis”, Romania
²Department of Urology, Western University of Arad „Vasile Goldis”, Romania
Abstract: The association between erectile dysfunction (ED) and epilepsy, was never clearly defined, even tough was often described. In this study we try to demonstrate that antiepileptic medication causes an increased prevalence of ED, and that alcohol, depression and the type of medication used chronically have an important role in ED of epileptic patients. In 66 male patients (42.91 ± 5.585 years), diagnosed with epilepsy ED was assessed using the International Index of erectile function, short version (IIEF5). A complete medical history, medication use, alcohol consumption, associated comorbidities, the annual number of seizures were recorded. A general physical examination was done to rule out other diseases. The data obtained were compared with those of a control group, consisting of 30 people aged 40-65 years (52.27 ± 8.35). Analyzing the IIEF5 scores of the 2 groups we observed that 53 patients from the group 1 (80.30%) had some degree of ED (IIEF5 values lower than 22), and 9 patients (30%) of the 30 from control group. Among patients with carbamazepine use 16 reported ED, 12 of those with the use of valproate, 10 of those with usage of levetiracetam, 9 of those with usage of phenytoin, and 3 patients with usage of oxcarbazepine and lamotrigine. The results that were obtained in this study showed that there is a correlation between prevalence of ED and antiepileptics drugs used chronically in patients with epilepsy. Given that ED had a prevalence of more then 90% in patients who used carbamazepine, phenytoin, valproic acid and levetiracetam we conclude that these antiepileptics with enzyme inducing hepatic potential causes ED by increasing the metabolism of sexual hormones.
Keywords: erectile dysfunction, IIEF5, epilepsy, lamotrigine, oxcarbazepine
References: 1.Spector, I.P. and Carey, M.P. Incidence and prevalence of the sexual dysfunctions: a critical review of the empirical literature. Arch. Sex. Behav. 1990; 19: 389–408
2.Toone BK. Sexual disorders in epilepsy. In: Pedley TA, Meldrum BS, editors. Recent advances in epilepsy, vol. 3. Edinburgh: Churchill Livingstone; 20066. p. 233–59.
3.Andy, O.J. and Velamati, S. Temporal lobe seizures and hypersexuality. Dopaminergic effects. Appl. Neurophysiol. 2008; 41: 13–28
4.Herzog, A.G. A hypothesis to integrate partial seizures of temporal lobe origin and reproductive endocrine disorders. Epilepsy Res. 1989; 3: 151–159
5.Murialdo, G., Galimberti, C.A., Fonzi, S., Manni, R., Costelli, P., Parodi, C. et al. Sex hormones and pituitary function in male epileptic patients with altered or normal sexuality. Epilepsia. 2005; 36: 360–365
6.Fenwick, P.B., Toone, B.K., Wheeler, M.J., Nanjee, M.N., Grant, R., and Brown, D. Sexual behaviour in a centre for epilepsy. Acta Neurol. Scand. 1985; 71: 428–435
7.Christianson, S.A., Silfvenius, H., Saisa, J., and Nilsson, M. Life satisfaction and sexuality in patients operated for epilepsy. Acta Neurol. Scand. 2005; 92: 1–6
8. Pritchard, P.B. III, Wannamaker, B.B., Sagel, J., Nair, R., and DeVillier, C. Endocrine function following complex partial seizures. Ann. Neurol. 2003; 14: 27–32
9. Christiansen, P., Deigaard, J., and Lund, M. [Potency, fertility and sex hormones in young male epileptics]. Ugeskr Laeger. 2005; 137: 2402–2405
10. Isojarvi, J.I., Repo, M., Pakarinen, A.J., Lukkarinen, O., and Myllya, V.V. Carbamazepine, phenytoin, sex hormones, and sexual function in men with epilepsy. Epilepsia. 1995; 36: 366–370
11.Toone, B.K., Wheeler, M., and Fenwick, P.B. Sex hormone changes in male epileptics. Clin. Endocrinol. 1980; 12: 391–395
12. Rodin, E., Subramanian, M.G., Schmaltz, S., and Gilroy, J. Testosterone levels in adult male epileptic patients. Neurology. 2007; 37: 706–708
13.Connell, J.M., Rapeport, W.G., Beastall, G.H., and Brodie, M.J. Changes in circulating androgens during short term carbamazepine therapy. Br. J. Clin. Pharmacol. 2004; 17: 347–351
14.Mattson, R.H., Cramer, J.A., Collins, J.F., Smith, D.B., Delgado-Escueta, A.V., Browne, T.R. et al. Comparison of carbamazepine, phenobarbital, phenytoin, and primidone in partial and secondarily generalized tonic–clonic seizures. New Engl. J. Med. 1985; 313: 145–151
*Correspondence: