Abstracts

Rationale: The aim of this study was to investigate possible differences in sexual function in epilepsy patients using either lamotrigine (LTG), carbamazepine (CBZ) or levetiracetam (LEV) as monotherapy, and to compare the results with healthy controls. Reduced sexual function has been reported in patients treated with enzyme inducing drugs like CBZ, and recent data from animal studies have indicated possible endocrine effects of LEV. No effects of LTG have so far been reported regarding sexual or endocrine function. Methods: 131 male and 100 female patients and 110 healthy controls (51 males, 59 females) from Norway and Austria within an age range of 18 to 45 were included. They had been treated with LEV (32 males, 26 females), CBZ (63 males, 30 females) or LTG (36 males, 44 females) as monotherapy for at least 6 months. Sexual function was monitored using the Arizona Sexual Experience Scale (ASEX). Five questions regarding sexual interest, arousal, lubrication/erection and degree of satisfaction are graded from 1 (highly satisfied) to 6 (major problems). Results: ASEX scores were significantly lower in women using LTG or LEV (more satisfied with their sexual life) compared to women using CBZ ( P= 0.001 and 0.001), and also when compared to controls (P<0.001 and 0.001). This accounts for all ASEX categories, except for lubrication in the LEV treated women. Women using CBZ were not different from the control group. Total ASEX scores for men were not significantly different in the three treatment groups and at the same level as controls. The only question where a small, but significant difference was found in males was for patients using CBZ, who reported less satisfaction with orgasm. Conclusions: Women treated with LTG or LEV were more satisfied with their sexual life than patients treated with CBZ. Interestingly, they were even more satisfied than healthy controls. This might be due to a psychotropic effect of the drugs, with an increase in mood. Males on LTG, LEV or CBZ reported no or only minor changes in sexual function.