Abstracts

Oxcarbazepine (OXC) is a novel antiepileptic drug (AED). The occurrence of reproductive dysfunction in women treated with OXC monotherapy for epilepsy has not been previously studied. However, in monkeys and mice OXC has been associated with decreaced fertility (Epilepsia 2000;41(7):97-98 J Pharmacol Exp Ther 1996; Dec;279(3):1237-1242). The aim of the study was to compare the effects of OXC and carbamazepine (CBZ) on reproductive endocrine function in women with epilepsy. We examined 35 women with epilepsy who were regularly seen in the outpatient Department of Neurology at Oulu University Hospital. We also examined 36 healthy control women without antiepileptic therapy. Nineteen patients were treated with OXC monotherapy, and sixteen patients were treated with CBZ monotherapy. The subjects were clinically examined, vaginal ultrasonography was performed, and serum sex hormone concentrations were measured. Women taking OXC or CBZ had lower serum testosterone (T) levels and Free Androgen Index (FAI) than the control subjects. CBZ medication was also associated with high serum sex hormone binding globulin (SHBG) concentrations. Patients on OXC monotherapy had higher concentrations of dehydroepiandrosterone sulphate (DHEAS) and androstendione (A) than women taking CBZ. In addition, increased DHEAS or A levels were more common in OXC treated women than in women on CBZ or control women. Moreover, the prevalence of polycystic ovaries (PCO) was high in OXC treated women. OXC and CBZ have different reproductive endocrine effects. Both OXC and CBZ were associated with low serum T concentrations and FAI. However, only CBZ was associated with high serum SHBG levels, while OXC was associated with high frequency of elevated levels of A and DHEAS, and increased prevalence of PCO. The findings of the present study suggest that the use of OXC may be disadvantageous in women with epilepsy and hyperandrogenism, while CBZ may be beneficial for those women. (Supported by Orion-Pharma Research Foundation.)