Reproductive effects of valproate, carbamazepine, and oxcarbazepine in menwith epilepsy

Background: Recent observations have indicated that reproductive endocrine disorders are common among women taking valproate (VPA) for epilepsy, but i t is not known whether respective abnormalities develop in men taking VPA f or epilepsy. Carbamazepine (CBZ) may induce endocrine disorders in men with epilepsy, but the endocrine effects of oxcarbazepine (OXC) are not known. Methods: Reproductive endocrine function was evaluated in 90 men taking VPA (n = 21), CBZ (n = 40), or OXC (n = 29) as monotherapy for epilepsy and in 25 healthy control men. Results: Twelve men (57%) taking VPA had increased serum androgen levels. The mean serum level of androstenedione was high in patients taking VPA. Serum levels of dehydroepiandrosterone sulfate were l ow, and serum concentrations of sex hormone-binding globulin (SHBG) were hi gh in men taking CBZ. The endocrine effects of OXC seemed to be dose-depend ent, because serum hormone levels were normal in patients with low OXC dose s (<900 mg/day), but serum concentrations of testosterone, gonadotropins, a nd SHBG were high in patients with a daily OXC dose <greater than or equal to>900 mg. Conclusions: VPA increases serum androgen concentrations in men with epilepsy. The endocrine effects of CBZ and OXC were different, because CBZ appears to decrease the bioactivity of androgens, whereas OXC does not .