Table 5.
Serum sex hormone and sex hormone-binding globulin (SHBG) concentrations in various studies
| AEDs | Sex (n) | SHBG | T | FT | DHEAS | DiT | FAI | E2 | A | Comments | References |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Carbamazepine, valproate | M (37) | ↑ | ↓ | ↓ | NA | NA | NA | NA | NA | Libido and fertility are low in epileptic patients | Dana-Haeri et al. (1982) |
| Carbamazepine, valproate, phenobarbital | M (72) | ↑ | ↑ | ↓ | ↓ | ↑ | ↓ | NA | NA | – | Toone et al. (1983) |
| Carbamazepine | M (06) | ↑ | ↑ | ↓ | ↓ | NA | NA | NA | NA | Induces changes in circulating androgen concentrations | Connell et al. (1984) |
| Phenytoin | M (20) | NA | ↑ | ↓ | NA | NA | NA | NA | NA | Reductions in free testosterone serum levels are associated with TLE in men | Herzog et al. (1986a) |
| Carbamazepine | F (23) | ↑ | ≠ | ≠ | ↓ | NA | ↓ | ≠ | NA | 1 year prospective data | Isojärvi (1990) |
| Carbamazepine | M (21) | ↑ | ≠ | ≠ | NA | NA | ↓ | ↓ | NA | 1 year prospective study | Isojärvi et al. (1991) |
| Carbamazepine | F (32) | ↑ | ≠ | NA | NA | NA | ≠ | ↓ | NA | Low estradiol/SHBG ratios associated with menstrual disorders | Isojarvi et al. (1995) |
| Carbamazepine, phenytoin, phenobarbital | M (37) | ↑ | ≠ | ↓ | ↓ | ↓ | NA | NA | NA | Decreased T/E2 ratio associated with hyposexuality | Murialdo et al. (1995) |
| carbamazepine | M (25) | ↑ | ≠ | NA | NA | NA | ↓ | NA | NA | High SHBG levels associated with diminished potency | Isojärvi et al. (1995) |
| Valproate, carbamazepine | F (65) | ↓ | ↑ | NA | ↑ | NA | NA | NA | ≠ | T concentration is more elevated in women initiating treatment at the age <20 years | Isojärvi et al. (1996) |
| Carbamazepine | F (23) | ≠ | ↓ | NA | ↓ | NA | ≠ | ↓ | NA | – | Murialdo et al. (1998) |
| Valproate | F (41) | ≠ | ↑ | NA | NA | NA | ↑ | ≠ | NA | Pre-pubertal, pubertal and Post-pubertal girls aged 8–18 year | Vainionpää et al. (1999) |
| Valproate | F (10) | ↑ | ↑ | NA | NA | NA | ≠ | ≠ | ↑ | 3 month prospective study | Rättyä et al. (2001) |
| Carbamazepine, lamotrigine, valproate, oxcarbazepine | M (70) | ≠ | ≠ | NA | ≠ | ↑ | NA | NA | NA | AEDs induce changes in circulating androgen concentrations | Mikkonen et al. (2004) |
| Carbamazepine | F (25) | ↑ | ↓ | NA | ≠ | NA | ↓ | ≠ | ≠ | Low E2/SHBG ratio is not associated with menstrual disorders | Löfgren et al. (2006) |
| Valproate, leviteracetam | M/F (20) | ≠ | ≠ | NA | ≠ | NA | NA | ≠ | ↑ | – | Rauchenzauner et al. (2010) |
| Topiramate | M (36) | NA | ↑ | ↓ | ↓ | NA | NA | NA | ↓ | Hormonal changes are associated with sexual dysfunction | Urso et al. (2014) |
| Primidone | M/F (20) | ↑ | ↓ | NA | NA | NA | NA | ↓ | NA | Leads to infertility in epilepsy patients | Luef and Madersbacher (2015) |
| Lacosamide | M (10) | ↓ | ↑ | NA | NA | NA | ↑ | NA | NA | Cause deinduction of CYP enzymes | Elger et al. (2016) |
AEDs anti-epileptic drugs, M male, F female, T testosterone, DHEAS dehydroepiandrosterone, DiT dihydrotestosterone, FT free testosterone, FAI free androgen index (100 × T/SHBG), E2 estradiol, A androstenedione, TLE temporal lobe epilepsy, NA not available
≠, unchanged; ↑, increased; ↓, decreased