A Comparative Study of the Effects of Valproate and Oxcarbazepine on Sexual Function, Sperm Quality, and Sex Hormones in Males with Epilepsy

Guo, Yi; Chen, Lang; Wu, Dongmei; Yu, Liang; Sun, Hongbin

doi:10.1155/2021/6624101

Cited by 8 publications

(4 citation statements)

References 34 publications

(52 reference statements)

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“…In comparison with non-epileptic men, those affected by epilepsy have been reported to have a higher likelihood of fertility issues; this is possibly associated with the sexual dysfunction issues, which have been reported in up to 71% of these patients [45]. Guo et al [46] prospectively evaluated the sperm quality of 44 young males with epilepsy (e.g., 23 being treated with valproic acid and 21 receiving oxcarbamazepine) and 30 age-matched healthy individuals. The sperm parameters were significantly reduced in those patients on valproic acid vs. both healthy individuals and those on carbamazepine.…”

Section: Discussionmentioning

confidence: 99%

The Possible Role of Prescribing Medications, Including Central Nervous System Drugs, in Contributing to Male-Factor Infertility (MFI): Assessment of the Food and Drug Administration (FDA) Pharmacovigilance Database

Baldini,

Khattak,

Capogrosso

et al. 2023

Brain Sciences

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Background: A wide range of medications may have a possible role in the development of male-factor infertility (MFI), including various antineoplastic agents, testosterone/anabolic steroids, immunosuppressive drugs/immunomodulators, glucocorticosteroids, non-steroidal anti-inflammatory drugs, opiates, antiandrogenic drugs/5-alpha-reductase inhibitors, various antibiotics, antidepressants, antipsychotics, antiepileptic agents and others. We aimed at investigating this issue from a pharmacovigilance-based perspective. Methods: The Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database was queried to identify the drugs associated the most with MFI individual reports. Only those drugs being associated with more than 10 MFI reports were considered for the disproportionality analysis. Proportional Reporting Ratios (PRRs) and their confidence intervals were computed for all the drugs identified in this way in January 2023. Secondary, ‘unmasking’, dataset analyses were carried out as well. Results: Out of the whole database, 955 MFI reports were identified, 408 (42.7%) of which were associated with 20 medications, which had more than 10 reports each. Within this group, finasteride, testosterone, valproate, diethylstilbestrol, mechloretamine, verapamil, lovastatin and nifedipine showed significant levels of actual disproportionate reporting. Out of these, and before unmasking, the highest PRR values were identified for finasteride, diethylstilbestrol and mechloretamine, respectively, with values of 16.0 (12.7–20.3), 14.3 (9.1–22.4) and 58.7 (36.3–95.9). Conclusions: A variety of several medications, a number of which were already supposed to be potentially linked with MFI based on the existing evidence, were associated with significant PRR levels for MFI in this analysis. A number of agents which were previously hypothesized to be associated with MFI were not represented in this analysis, suggesting that drug-induced MFI is likely under-reported to regulatory agencies. Reproductive medicine specialists should put more effort into the detection and reporting of these adverse drug reactions.

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Section: Discussionmentioning

confidence: 99%

The Possible Role of Prescribing Medications, Including Central Nervous System Drugs, in Contributing to Male-Factor Infertility (MFI): Assessment of the Food and Drug Administration (FDA) Pharmacovigilance Database

Baldini,

Khattak,

Capogrosso

et al. 2023

Brain Sciences

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“…Regarding valproic acid, research has found that the decreased expression of phosphorylated protein and Ki67 in the testis may affect the formation of the acrosome during sperm generation, leading to premature acrosome reactions and abnormal sperm heads. In clinical studies, the novel AED oxcarbazepine has been shown to increase sperm motility, concentration, and vitality ( Guo et al, 2021 ; Wu et al, 2018 ). The authors speculate that this may have a positive effect on sperm production and maturation by raising FSH and LH levels.…”

Section: Main Textmentioning

confidence: 99%

Effects of clinical medications on male fertility and prospects for stem cell therapy

Mo,

Zhao,

et al. 2023

Front. Cell Dev. Biol.

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An increasing number of men require long-term drug therapy for various diseases. However, the effects of long-term drug therapy on male fertility are often not well evaluated in clinical practice. Meanwhile, the development of stem cell therapy and exosomes treatment methods may provide a new sight on treating male infertility. This article reviews the influence and mechanism of small molecule medications on male fertility, as well as progress of stem cell and exosomes therapy for male infertility with the purpose on providing suggestions (recommendations) for evaluating the effect of drugs on male fertility (both positive and negative effect on male fertility) in clinical application and providing strategies for diagnosis and treatment of male infertility.

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“…[6][7][8] Moreover, in men, VPA can have detrimental effects on sperm quality and testicular function/volume and may cause infertility. 9,10 Although the prognosis for IGE is more favorable than for some other epilepsies, up to 15% of individuals with IGE remain refractory to treatment. 5,11 The ASM perampanel (PER) acts as a noncompetitive antagonist of the αamino-3-hydroxy-5-methyl-4isoxazolepropionic acid receptor, 12,13 and it is widely approved for the treatment of focal onset seizures and the treatment of GTCS in people with IGE.…”

Section: Introductionmentioning

confidence: 99%

“…However, the use of VPA in women of childbearing age is limited due to its teratogenic effects, and its negative neurodevelopmental effects on in utero exposed children 6–8 . Moreover, in men, VPA can have detrimental effects on sperm quality and testicular function/volume and may cause infertility 9,10 . Although the prognosis for IGE is more favorable than for some other epilepsies, up to 15% of individuals with IGE remain refractory to treatment 5,11 …”

Section: Introductionmentioning

confidence: 99%

Perampanel for the treatment of people with idiopathic generalized epilepsy in clinical practice

Trinka

Alsaadi²,

Goji

et al. 2023

Epilepsia

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ObjectiveThis study was undertaken to evaluate perampanel (PER) when used under real‐world conditions to treat people with idiopathic generalized epilepsy (IGE) included in the PERaMpanel pooled analysIs of effecTiveness and tolerability (PERMIT) study.MethodsThe multinational, retrospective, pooled analysis PERMIT explored the use of PER in people with focal and generalized epilepsy treated in clinical practice across 17 countries. This subgroup analysis included PERMIT participants with IGE. Time points for retention and effectiveness measurements were 3, 6, and 12 months (last observation carried forward, defined as "last visit," was also applied to effectiveness). Effectiveness was evaluated by seizure type (total seizures, generalized tonic–clonic seizures [GTCS], myoclonic seizures, absence seizures) and included ≥50% responder rate and seizure freedom rate (defined as no seizures since at least the previous visit). Safety/tolerability was monitored throughout PER treatment and evaluated by documenting the incidence of adverse events (AEs), including psychiatric AEs and those leading to treatment discontinuation.ResultsThe Full Analysis Set included 544 people with IGE (51.9% women, mean age = 33.3 years, mean epilepsy duration = 18.1 years). At 3, 6, and 12 months, 92.4%, 85.5%, and 77.3% of participants were retained on PER treatment, respectively (Retention Population, n = 497). At the last visit, responder and seizure freedom rates were, respectively, 74.2% and 54.6% (total seizures), 81.2% and 61.5% (GTCS), 85.7% and 66.0% (myoclonic seizures), and 90.5% and 81.0% (absence seizures) (Effectiveness Population, n = 467). AEs occurred in 42.9% of patients and included irritability (9.6%), dizziness/vertigo (9.2%), and somnolence (6.3%) (Tolerability Population, n = 520). Treatment discontinuation due to AEs was 12.4% over 12 months.SignificanceThis subgroup analysis of the PERMIT study demonstrated the effectiveness and good tolerability of PER in people with IGE when administered under everyday clinical practice conditions. These findings are in line with clinical trial evidence, supporting PER's use as broad‐spectrum antiseizure medication for the treatment of IGE.

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A Comparative Study of the Effects of Valproate and Oxcarbazepine on Sexual Function, Sperm Quality, and Sex Hormones in Males with Epilepsy

Cited by 8 publications

References 34 publications

The Possible Role of Prescribing Medications, Including Central Nervous System Drugs, in Contributing to Male-Factor Infertility (MFI): Assessment of the Food and Drug Administration (FDA) Pharmacovigilance Database

The Possible Role of Prescribing Medications, Including Central Nervous System Drugs, in Contributing to Male-Factor Infertility (MFI): Assessment of the Food and Drug Administration (FDA) Pharmacovigilance Database

Effects of clinical medications on male fertility and prospects for stem cell therapy

Perampanel for the treatment of people with idiopathic generalized epilepsy in clinical practice

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