Antiepileptic drug therapy and sexual function in men with epilepsy

Purpose: To study the effects of antiepileptic drugs (AEDs) on sex hormone levels and sexual activity in a group of men attending a hospital-based epi lepsy clinic. Methods: One hundred eighteen men being treated with AED therapy, 32 with e pilepsy but not receiving AEDs, and 34 controls were recruited. All subject s were aged 18-65 years. Blood (20 ml) was removed for hormone assays, afte r which each subject completed a validated questionnaire [Sexuality Experie nce Scores (Frenken and Vennix, 1981)] aimed at exploring the individuals' sexual activity and attitudes to sexual morality. Results: Men taking carbamazepine (CBZ) only had significantly higher mean sex hormone-binding globulin (SHBG) levels than the control group. The CBZ group also had a significantly lower mean DHEAS concentration than the cont rol, untreated, and sodium valproate (VPA) monotherapy groups. The phenytoi n monotherapy group (PHT) had a significantly higher mean SHBG than both th e control and untreated groups, and had a significantly higher mean total t estosterone (TT) value than the control untreated, CBZ, and VPA groups, and a significantly lower mean DHEAS than the controls, untreated, and VPA gro ups. Men receiving more than one AED had significantly higher mean SHBG con centrations compared with control, untreated, and VPA groups. In addition, the polytherapy group's mean TT was significantly higher than the control a nd VPA groups, although its mean DHEAS concentration was lower than the con trol, untreated, and VPA groups. There were no significant differences betw een the study groups in mean FT, Budrostenedione (AMD), or estradiol levels . But the CBZ, PHT, and polytherapy groups had significantly lower mean fre e and rogen index (FAI) than the controls. The CBZ group had a lower mean F AI than the VPA group. The polytherapy group had a lower FAI than the untre ated group. Sexuality Experience Scores (SES) showed that those men receivi ng AEDs embraced a stricter sexual morality than the controls and untreated , and expressed greater satisfaction with their marriages than the control and untreated groups. Conclusions: Seizure type did not affect SES scores. Multiple regression sh owed men who had received further education were less accepting of strict s exual morality.