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.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Antiepileptic drug use and rates of hip bone loss in older men: A prospective study
Ensrud et al.
Neurology 2008;71:723-730.
ABSTRACT | FULL TEXT  

Sexual function in men with epilepsy: How important is testosterone?
Talbot et al.
Neurology 2008;70:1346-1352.
ABSTRACT | FULL TEXT  

Antiepileptic drug use and birth rate in patients with epilepsy--a population-based cohort study in Finland
Artama et al.
Hum Reprod 2006;21:2290-2295.
ABSTRACT | FULL TEXT  

Differential effects of antiepileptic drugs on sexual function and hormones in men with epilepsy
Herzog et al.
Neurology 2005;65:1016-1020.
ABSTRACT | FULL TEXT  

Reproductive health effects and teratogenicity of antiepileptic drugs
Kaplan
Neurology 2004;63:S13-S23.
ABSTRACT | FULL TEXT  

Antiepileptic drug use increases rates of bone loss in older women: A prospective study
Ensrud et al.
Neurology 2004;62:2051-2057.
ABSTRACT | FULL TEXT  

Effect of epilepsy and antiepileptic drugs on male reproductive health
Isojarvi et al.
Neurology 2004;62:247-253.
ABSTRACT | FULL TEXT  

Reproductive dysfunction in women with epilepsy
Isojarvi
Neurology 2003;61:S27-34.
ABSTRACT | FULL TEXT  

Reproductive dysfunction in women with epilepsy: recommendations for evaluation and management
Bauer et al.
J. Neurol. Neurosurg. Psychiatry 2002;73:121-125.
ABSTRACT | FULL TEXT  

Antiepileptic Drug-Induced Bone Loss in Young Male Patients Who Have Seizures
Andress et al.
Arch Neurol 2002;59:781-786.
ABSTRACT | FULL TEXT  

Early hormonal changes during valproate or carbamazepine treatment: A 3-month study
Rattya et al.
Neurology 2001;57:440-444.
ABSTRACT | FULL TEXT  

Reproductive effects of valproate, carbamazepine, and oxcarbazepine in men with epilepsy
Rattya et al.
Neurology 2001;56:31-36.
ABSTRACT | FULL TEXT  

Serum androgens return to normal after temporal lobe epilepsy surgery in men
Bauer et al.
Neurology 2000;55:820-824.
ABSTRACT | FULL TEXT  

Melatonin's Role as an Anticonvulsant and Neuronal Protector: Experimental and Clinical Evidence
Munoz-Hoyos et al.
J Child Neurol 1998;13:501-509.
ABSTRACT  

Polycystic Ovaries and Hyperandrogenism in Women Taking Valproate for Epilepsy
Isojarvi et al.
NEJM 1993;329:1383-1388.
ABSTRACT | FULL TEXT