Serum hormones in male epileptic patients receiving anticonvulsant medication
J. I. Isojarvi, A. J. Pakarinen, P. J. Ylipalosaari and V. V. Myllyla
Department of Neurology, University of Oulu, Finland.
Circulating sex and thyroid hormones, as well as the pituitary function,
were assessed in 63 male patients with epilepsy receiving either a single
medication of carbamazepine, phenytoin, or valproate or a combination of
carbamazepine plus phenytoin or carbamazepine plus valproate. All
therapeutic regimens, including carbamazepine and/or phenytoin were
associated with low levels of circulating thyroxine (T4), free thyroxine
(FT4), and dehydroepiandrosterone sulfate, and with low values for the free
androgen index, and phenytoin and carbamazepine plus phenytoin were
associated with high serum concentrations of sex hormone-binding globulin.
These hormone parameters were unaffected by valproate monotherapy. It seems
probable that accelerated hormone metabolism is responsible for the
hormonal changes found in patients treated with carbamazepine and/or
phenytoin. However, every drug regimen studied also had depressant and/or
stimulatory effects on the function of the hypothalamic-pituitary axis. The
diverse endocrine effects of different antiepileptic drug regimens should
be considered when starting antiepileptic drug therapy.
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Ensrud et al.
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Kaplan
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Ensrud et al.
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Isojarvi et al.
Neurology 2004;62:247-253.
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Early hormonal changes during valproate or carbamazepine treatment: A 3-month study
Rattya et al.
Neurology 2001;57:440-444.
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Reproductive effects of valproate, carbamazepine, and oxcarbazepine in men with epilepsy
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Neurology 2001;56:31-36.
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Serum androgens return to normal after temporal lobe epilepsy surgery in men
Bauer et al.
Neurology 2000;55:820-824.
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Melatonin's Role as an Anticonvulsant and Neuronal Protector: Experimental and Clinical Evidence
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J Child Neurol 1998;13:501-509.
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Polycystic Ovaries and Hyperandrogenism in Women Taking Valproate for Epilepsy
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