Effects of carbamazepine and oxcarbazepine on the reproductive endocrine function in women with epilepsy.
OBJECTIVE
The aim of the study was to compare the effects of carbamazepine (CBZ) and oxcarbazepine (OXC) on the reproductive endocrine function in women with epilepsy. OXC is a novel antiepileptic drug (AED), and the occurrence of reproductive dysfunction in women treated with OXC monotherapy for epilepsy has not been studied previously.


METHODS
Thirty-five women with epilepsy were examined in the Department of Neurology at Oulu University Hospital. Sixteen patients were treated with CBZ monotherapy, and nineteen patients were treated with OXC monotherapy. The subjects were clinically examined, vaginal ultrasonography was performed, and serum sex hormone concentrations were measured.


RESULTS
The women taking CBZ or OXC had lower serum testosterone (T) levels and lower free androgen indexes (FAIs) than the control subjects. CBZ medication was associated with increased concentrations of serum sex hormone-binding globulin (SHBG). The patients taking OXC had higher concentrations of dehydroepiandrosterone sulfate (DHEAS) and androstendione (A) than did the women taking CBZ. Moreover, the prevalence of polycystic ovaries (PCOs) was high in the OXC-treated women.


CONCLUSIONS
CBZ and OXC have different effects on the reproductive endocrine function. Although both drugs were associated with low serum T concentrations and low FAIs, only OXC was associated with a high frequency of elevated levels of A and DHEAS and with an increased prevalence of PCOs. These findings suggest that OXC may be disadvantageous for women with epilepsy and hyperandrogenism, whereas CBZ may be beneficial for these women.
Löfgren
Eeva
E
Department of Neurology, University of Oulu, Oulu, Finland. eeva.lofgren@oulu.fi
Tapanainen
Juha S
JS
Koivunen
Riitta
R
Pakarinen
Arto
A
Isojärvi
Jouko I T
JI
D000293:Adolescent; D000328:Adult; D000728:Androgens / Q000097:blood; D000735:Androstenedione / Q000097:blood; D000927:Anticonvulsants / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D002220:Carbamazepine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use*; D015897:Comorbidity; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood*; D004827:Epilepsy / Q000097:blood* / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000097:blood / Q000139:chemically induced / Q000453:epidemiology*; D008599:Menstruation Disturbances / Q000097:blood / Q000453:epidemiology; D000078330:Oxcarbazepine; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000139:chemically induced / Q000453:epidemiology*; D011374:Progesterone / Q000097:blood; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000097:blood
D000728:Androgens; D000927:Anticonvulsants; D012738:Sex Hormone-Binding Globulin; D002220:Carbamazepine; D013739:Testosterone; D000735:Androstenedione; D011374:Progesterone; D019314:Dehydroepiandrosterone Sulfate; D000078330:Oxcarbazepine