Az epilepszia es a férfi nemi muködes zavara

okok, diagnózis es terápia.

Translated title of the contribution: Epilepsy and male sexual dysfunction: etiology, diagnosis and therapy

Beáta Bóné, J. Janszky

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

While 10% of healthy men had sexual dysfunctions, male epilepsy patients experience sexual problems in 40-70%. The cause of sexual dysfunction in epilepsy is multifactorial, but there are three main factors: the epilepsy itself, antiepileptic treatment and psychiatric/psychic problems. Antiepileptics with hepatic enzyme induction potential (carbamazepine, phenytoin) enhance the metabolism of sexual steroids. Valproic acid as an enzyme inhibitor and drug with high protein binding affinity elevates the free serum levels of androgens. Certain antiepileptic drugs may have negative cognitive side effects, some of them can induce psychiatric disorders. These drugs can facilitate male sexual dysfunctions through these psychic side effects. The metabolic and endocrine alterations caused by carbamazepine may return to normal level after replacement of carbamazepine with oxcarbazepine. After an oxcarbazepine-carbamazepine replacement, carbamazepine-induced impotency can be cured. According some new data lamotrigine can also help in sexual dysfunction. The therapy of sexual dysfunction in epilepsy depends on its cause. In cases of hormonal alterations, the fist step is a change of antiepileptic regimen. Instead of enzyme-inductor antiepileptics and valproate, new antiepileptic drugs should be prescribed. At present, the most investigated antiepileptic drug is the oxcarbazepine with positive effect on antiepileptic-induced male sexual dysfunction, however, lamotrigine seems to be also beneficial. If the hormonal and sexual dysfunctions cannot be eliminated by drug changes, androgenic therapy or bromocriptine may be required. Testosterone may not only be beneficial on sexual functions, but can reduce also the seizure frequency. Independent of etiology, erectile dysfunctions can be successfully treated by sildenafil.

Original languageHungarian
Pages (from-to)148-152
Number of pages5
JournalIdeggyógyászati szemle
Volume59
Issue number5-6
Publication statusPublished - May 20 2006

Fingerprint

Anticonvulsants
Epilepsy
Carbamazepine
Valproic Acid
Therapeutics
Psychiatry
Pharmaceutical Preparations
Enzyme Induction
Bromocriptine
Phenytoin
Enzyme Inhibitors
Erectile Dysfunction
Protein Binding
Androgens
Testosterone
Seizures
Steroids
Liver
Enzymes
Serum

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Az epilepszia es a férfi nemi muködes zavara : okok, diagnózis es terápia. / Bóné, Beáta; Janszky, J.

In: Ideggyógyászati szemle, Vol. 59, No. 5-6, 20.05.2006, p. 148-152.

Research output: Contribution to journalArticle

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