Differential effects of levetiracetam, carbamazepine, and lamotrigine on reproductive endocrine function in adults

Review: <i>Pharmaceutical and personal care products (PPCPs) as endocrine disrupting contaminants (EDCs) in South African surface waters</i>

“…In men using levetiracetam and valproate as treatment, it has been shown that these drugs can lead to increased T and steroid hormone-binding globulin (SHBG) levels, which is responsible for the transport of steroid hormones in blood plasma (Rättyä et al, 2001;Harden et al, 2010). In the same studies, it was shown that men treated with carbamazepine also evidenced increased levels of SHBG, pituitary FSH and LH (Herzog et al, 2005;Svalheim et al, 2009). Therefore, it might be possible that anticonvulsant compounds found in drinking water resources can lead to altered steroidogenesis in men.…”

“…In particular, the anticonvulsant drug carbamazepine was detected in 63% of tap water tested in these regions (Table 1; Patterton, 2013). Anticonvulsant drugs, such as carbamazepine, levetiracetam, lamotrigine and valproate, have been shown to cause several reproductive endocrine system side-effects in men and women suffering from epilepsy (Table 2; Rättyä et al, 2001;Svalheim et al, 2009;Harden et al, 2010), as well as in fish species exposed to carbamazepine (Galus et al, 2013). In men using levetiracetam and valproate as treatment, it has been shown that these drugs can lead to increased T and steroid hormone-binding globulin (SHBG) levels, which is responsible for the transport of steroid hormones in blood plasma (Rättyä et al, 2001;Harden et al, 2010).…”

Hormonal consequences of epilepsy and its treatment in men

“…This is all the more pertinent since there was, in fact, a sizable difference in sexual function scores between the two groups; it failed to reach statistical significance, which might have been simply a function of statistical power. On the other hand, reinforcing these authors' viewpoint was another recent study which found no differences in sexual function in men on CBZ relative to LTG-treated, LEV-treated, and control subjects [47].…”

“…Another investigation with a more diversely-treated group of patients also found lower free testosterone levels among inducer-treated patients than among noninducer-treated patients [15]. However, one group found that men treated with CBZ, LTG, or LEV all had reduced free testosterone relative to controls [47]. To complicate matters further, a recent study reported in abstract form using prospective repeated-measures methodology found that 3 of 5 men experienced an increase in testosterone after being treated with LEV [48].…”

“…LTG is well-established to have antidepressant effects, and in light of the findings of Talbot et al [15], one might speculate that improvement in mood due to LTG treatment could have led to enhanced sexual function. Any such hypothesis remains speculative at present, particularly since the most recent study found no evidence of enhanced sexual function in LTGtreated men [47].…”