Effects of lamotrigine on sex hormone, seminal fluid and sexual function of male patients with epilepsy_Journal of Epilepsy

Authors：

WU Dongmei ^1,2 ,  SUN Hongbin ^1,2

1. Southwest Medical University, Luzhou 646000, China;
2. Department of Neurology, Sichuan Province People’s Hospital, Chengdu 610041, China;

Corresponding author：

SUN Hongbin, Email: shb1369@aliyun.com

Keywords：

Epilepsy; Lamotrigine; Sexual function; Seminal fluid; Sex hormone

DOI：

10.7507/2096-0247.20180007

Video：

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Objective To investigate the influence of Lamotrigine (LTG) on sex hormone, seminal fluid and sexual function in male epilepsy patients. Methods The blood sex hormone levels and sperm quality were detected in 20 normal controls and 16 male epilepsy patients in Epilepsy Center of Sichuan Province People's Hospital from April 2015 to November 2016. All participants were detected before taking medicine and after being treated with LTG monotherapy for 1 year. The international index of erectile function-5 (IIEF-5) was employed to assess the sexual function in the groups above, and the results were compared. Results Compared with the control group, the total number of sperm, the rate of forward movement, survival, normal sperm and the score of IIEF-5 in the untreated group were less (P<0.05). LTG treatment group's sperm parameters and the score of IIEF-5 seemed improve, but there was no statistically significant difference (P>0.05). There was no significant difference in sexual hormones between the groups above (P>0.05). Conclusions Semen quality and the score of IIEF-5 in epileptic male decline more easily; LTG might improve the semen quality and sexual function, but no significant difference has being found.

Citation： WU Dongmei, SUN Hongbin. Effects of lamotrigine on sex hormone, seminal fluid and sexual function of male patients with epilepsy. Journal of Epilepsy, 2018, 4(1): 27-31. doi: 10.7507/2096-0247.20180007 Copy

1.	Hamed SA. The effect of epilepsy and antiepileptic drugs on sexual, reproductive and gonadal health of adults with epilepsy. Expert Rev Clin Pharmacol, 2016, 9(6): 807-819.
2.	Xiaotian X, Hengzhong Z, Yao X, et al. Effects of antiepileptic drugs on reproductive endocrine function, sexual function and sperm parameters in Chinese han men with epilepsy. J Clin Neurosci, 2013, 20(11): 1492-1497.
3.	Blume WT. Low fertility in men with epilepsy: unhappy, uninterested, unable. Epilepsy Curr, 2009, 9(3): 69-70.
4.	Verrotti A, Mencaroni E, Cofini M, et al. Valproic acid metabolism and its consequences on sexual functions. Curr Drug Metab, 2016, 17(6): 573-581.
5.	Luef G, Kramer G, Stefan H. Oxcarbazepine treatment in male epilepsy patients improves pre-existing sexual dysfunction. Acta Neurol Scand, 2009, 119(2): 94-99.
6.	Calabro RS, Italiano D, Pollicino P, et al. Oxcarbazepine-related retrograde ejaculation. Epilepsy Behav, 2012, 25(2): 174-175.
7.	Yamamoto Y, Inoue Y, Matsuda K, et al. Influence of concomitant antiepileptic drugs on plasma lamotrigine concentration in adult Japanese epilepsy patients. Biol Pharm Bull, 2012, 35(4): 487-493.
8.	Rosen RC, Cappelleri JC, Gendrano N 3rd. The International Index of Erectile Function (IIEF): a state-of-the-science review. Int J Impot Res, 2002, 14(4): 226-244.
9.	Hamed SA. Neuroendocrine hormonal conditions in epilepsy: relationship to reproductive and sexual functions. Neurologist, 2008, 14(3): 157-169.
10.	Malatkova P, Havlikova L, Wsol V. The role of carbonyl reducing enzymes in oxcarbazepine in vitro metabolism in man. Chem Biol Interact, 2014, 220: 241-247.
11.	Harden CL, Nikolov BG, Kandula P, et al. Effect of levetiracetam on testosterone levels in male patients. Epilepsia, 2010, 51(11): 2348-2351.
12.	Calabro RS, Ferlazzo E, Bramanti P. Oxcarbazepine-related male infertility. Epilepsy Behav, 2010, 19(4): 665.
13.	Svalheim S, Sveberg L, Mochol M, et al. Interactions between antiepileptic drugs and hormones. Seizure, 2015, 28（2）: 12-17.
14.	Ramaratnam S, Panebianco M, Marson AG. Lamotrigine add-on for drug-resistant partial epilepsy. Cochrane Database Syst Rev, 2016, 6: CD001909.
15.	Herzog AG, Drislane FW, Schomer DL, et al. Differential effects of antiepileptic drugs on sexual function and reproductive hormones in men with epilepsy: interim analysis of a comparison between lamotrigine and enzyme-inducing antiepileptic drugs. Epilepsia, 2004, 45(7): 764-768.
16.	Isojarvi JI, Lofgren E, Juntunen KS, et al. Effect of epilepsy and antiepileptic drugs on male reproductive health. Neurology, 2004, 62(2): 247-253.
17.	Verrotti A, Loiacono G, Laus M, et al. Hormonal and reproductive disturbances in epileptic male patients: emerging issues. Reprod Toxicol, 2011, 31(4): 519-527.
18.	Spencer D. Levetiracetam in men with epilepsy: testosterone is left alone but sperm count is paramount. Epilepsy Curr, 2017, 17(2): 99-100.
19.	Svalheim S, Tauboll E, Luef G, et al. Differential effects of levetiracetam, carbamazepine, and lamotrigine on reproductive endocrine function in adults. Epilepsy Behav, 2009, 16(2): 281-287.
20.	Herzog AG, Drislane FW, Schomer DL, et al. Differential effects of antiepileptic drugs on neuroactive steroids in men with epilepsy. Epilepsia, 2006, 47(11): 1945-1948.
21.	Gil-Nagel A, Lopez-Munoz F, Serratosa JM, et al. Effect of lamotrigine on sexual function in patients with epilepsy. Seizure, 2006, 15(3): 142-149.
22.	Hamed SA, Moussa EM, Tohamy AM, et al. Seminal fluid analysis and testicular volume in adults with epilepsy receiving valproate. J Clin Neurosci, 2015, 22(3): 508-512.
23.	Asadi-Pooya A, Farazdaghi M, Ashjazadeh N. Effects of carbamazepine on semen parameters in men with newly diagnosed epilepsy. Iran J Neurol, 2015, 14(3): 168-170.
24.	Baysal M, Ilgin S, Kilic G, et al. Reproductive toxicity after levetiracetam administration in male rats: Evidence for role of hormonal status and oxidative stress. PLoS One, 2017, 12(4): e0175990.
25.	Kose-Ozlece H, Ilik F, Cecen K, et al. Alterations in semen parameters in men with epilepsy treated with valproate. Iran J Neurol, 2015, 14(3): 164-167.
26.	Artama M, Isojarvi J I, Raitanen J, et al. Birth rate among patients with epilepsy: a nationwide population-based cohort study in Finland. Am J Epidemiol, 2004, 159(11): 1057-1063.
27.	Morrell MJ, Sperling MR, Stecker M, et al. Sexual dysfunction in partial epilepsy: a deficit in physiologic sexual arousal. Neurology, 1994, 44(2): 243-247.
28.	Jobst BC, Cascino GD. Resective epilepsy surgery for drug-resistant focal epilepsy: a review. JAMA, 2015, 313(3): 285-293.
29.	Calabro RS, Italiano D, Militi D, et al. Levetiracetam-associated loss of libido and anhedonia. Epilepsy Behav, 2012, 24(2): 283-284.

1. Hamed SA. The effect of epilepsy and antiepileptic drugs on sexual, reproductive and gonadal health of adults with epilepsy. Expert Rev Clin Pharmacol, 2016, 9(6): 807-819.
2. Xiaotian X, Hengzhong Z, Yao X, et al. Effects of antiepileptic drugs on reproductive endocrine function, sexual function and sperm parameters in Chinese han men with epilepsy. J Clin Neurosci, 2013, 20(11): 1492-1497.
3. Blume WT. Low fertility in men with epilepsy: unhappy, uninterested, unable. Epilepsy Curr, 2009, 9(3): 69-70.
4. Verrotti A, Mencaroni E, Cofini M, et al. Valproic acid metabolism and its consequences on sexual functions. Curr Drug Metab, 2016, 17(6): 573-581.
5. Luef G, Kramer G, Stefan H. Oxcarbazepine treatment in male epilepsy patients improves pre-existing sexual dysfunction. Acta Neurol Scand, 2009, 119(2): 94-99.
6. Calabro RS, Italiano D, Pollicino P, et al. Oxcarbazepine-related retrograde ejaculation. Epilepsy Behav, 2012, 25(2): 174-175.
7. Yamamoto Y, Inoue Y, Matsuda K, et al. Influence of concomitant antiepileptic drugs on plasma lamotrigine concentration in adult Japanese epilepsy patients. Biol Pharm Bull, 2012, 35(4): 487-493.
8. Rosen RC, Cappelleri JC, Gendrano N 3rd. The International Index of Erectile Function (IIEF): a state-of-the-science review. Int J Impot Res, 2002, 14(4): 226-244.
9. Hamed SA. Neuroendocrine hormonal conditions in epilepsy: relationship to reproductive and sexual functions. Neurologist, 2008, 14(3): 157-169.
10. Malatkova P, Havlikova L, Wsol V. The role of carbonyl reducing enzymes in oxcarbazepine in vitro metabolism in man. Chem Biol Interact, 2014, 220: 241-247.
11. Harden CL, Nikolov BG, Kandula P, et al. Effect of levetiracetam on testosterone levels in male patients. Epilepsia, 2010, 51(11): 2348-2351.
12. Calabro RS, Ferlazzo E, Bramanti P. Oxcarbazepine-related male infertility. Epilepsy Behav, 2010, 19(4): 665.
13. Svalheim S, Sveberg L, Mochol M, et al. Interactions between antiepileptic drugs and hormones. Seizure, 2015, 28（2）: 12-17.
14. Ramaratnam S, Panebianco M, Marson AG. Lamotrigine add-on for drug-resistant partial epilepsy. Cochrane Database Syst Rev, 2016, 6: CD001909.
15. Herzog AG, Drislane FW, Schomer DL, et al. Differential effects of antiepileptic drugs on sexual function and reproductive hormones in men with epilepsy: interim analysis of a comparison between lamotrigine and enzyme-inducing antiepileptic drugs. Epilepsia, 2004, 45(7): 764-768.
16. Isojarvi JI, Lofgren E, Juntunen KS, et al. Effect of epilepsy and antiepileptic drugs on male reproductive health. Neurology, 2004, 62(2): 247-253.
17. Verrotti A, Loiacono G, Laus M, et al. Hormonal and reproductive disturbances in epileptic male patients: emerging issues. Reprod Toxicol, 2011, 31(4): 519-527.
18. Spencer D. Levetiracetam in men with epilepsy: testosterone is left alone but sperm count is paramount. Epilepsy Curr, 2017, 17(2): 99-100.
19. Svalheim S, Tauboll E, Luef G, et al. Differential effects of levetiracetam, carbamazepine, and lamotrigine on reproductive endocrine function in adults. Epilepsy Behav, 2009, 16(2): 281-287.
20. Herzog AG, Drislane FW, Schomer DL, et al. Differential effects of antiepileptic drugs on neuroactive steroids in men with epilepsy. Epilepsia, 2006, 47(11): 1945-1948.
21. Gil-Nagel A, Lopez-Munoz F, Serratosa JM, et al. Effect of lamotrigine on sexual function in patients with epilepsy. Seizure, 2006, 15(3): 142-149.
22. Hamed SA, Moussa EM, Tohamy AM, et al. Seminal fluid analysis and testicular volume in adults with epilepsy receiving valproate. J Clin Neurosci, 2015, 22(3): 508-512.
23. Asadi-Pooya A, Farazdaghi M, Ashjazadeh N. Effects of carbamazepine on semen parameters in men with newly diagnosed epilepsy. Iran J Neurol, 2015, 14(3): 168-170.
24. Baysal M, Ilgin S, Kilic G, et al. Reproductive toxicity after levetiracetam administration in male rats: Evidence for role of hormonal status and oxidative stress. PLoS One, 2017, 12(4): e0175990.
25. Kose-Ozlece H, Ilik F, Cecen K, et al. Alterations in semen parameters in men with epilepsy treated with valproate. Iran J Neurol, 2015, 14(3): 164-167.
26. Artama M, Isojarvi J I, Raitanen J, et al. Birth rate among patients with epilepsy: a nationwide population-based cohort study in Finland. Am J Epidemiol, 2004, 159(11): 1057-1063.
27. Morrell MJ, Sperling MR, Stecker M, et al. Sexual dysfunction in partial epilepsy: a deficit in physiologic sexual arousal. Neurology, 1994, 44(2): 243-247.
28. Jobst BC, Cascino GD. Resective epilepsy surgery for drug-resistant focal epilepsy: a review. JAMA, 2015, 313(3): 285-293.
29. Calabro RS, Italiano D, Militi D, et al. Levetiracetam-associated loss of libido and anhedonia. Epilepsy Behav, 2012, 24(2): 283-284.

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Effects of lamotrigine on sex hormone, seminal fluid and sexual function of male patients with epilepsy

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