CARBAMAZEPINE, PHENYTOIN, SEX-HORMONES, AND SEXUAL FUNCTION IN MEN WITH EPILEPSY

We evaluated the effects of carbamazepine (CBZ) on serum androgen leve ls and sexual function prospectively for 5 years in 11 men with epilep sy and in 25 patients receiving either CBZ (14 patients) or phenytoin (PHT) (11) monotherapy for >5 years. Serum sex hormone binding globuli n (SHBG) levels increased and free androgen index (FAI) decreased duri ng CBZ treatment, and these changes correlated with duration of CBZ th erapy. Similarly, serum SHBG levels increased and FAI values decreased in patients receiving PHT for >5 years. CBZ and PHT increase serum SH BG levels, leading to decreased FAI. These drug-related hormonal chang es may be the primary cause of hyposexuality common in men with epilep sy.