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Cited by 173Pharmacological Effects and Toxicity StudiesEpilepsy research and treatmentEffects and risks of endocrine disrupting chemicals

Interactions between antiepileptic drugs and hormones

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Svalheim, Sigrid, Sveberg, Line, Mochol, Monika, Taubøll, Erik·2015·Seizure
DOI 10.1016/j.seizure.2015.02.022
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Abstract

Antiepileptic drugs (AEDs) are known to have endocrine side effects in both men and women. These can affect fertility, sexuality, thyroid function, and bone health, all functions of major importance for well-being and quality of life. The liver enzyme inducing antiepileptic drugs (EIAEDs), like phenobarbital, phenytoin, and carbamazepine, and also valproate (VPA), a non-EIAED, are most likely to cause such side effects. AED treatment can alter the levels of different sex hormones. EIAEDs increase sex hormone binding globulin (SHBG) concentrations in both men and women. Over time, this elevation can lead to lower levels of bioactive testosterone and estradiol, which may cause menstrual disturbances, sexual problems, and eventually reduced fertility. VPA can cause weight gain in both men and women. In women, VPA can also lead to androgenization with increased serum testosterone concentrations, menstrual disturbances, and polycystic ovaries. Lamotrigine has not been shown to result in endocrine side effects. The newer AEDs have not yet been thoroughly studied, but case reports indicate that some of these drugs could also be suspected to cause such effects if endocrine changes commence after treatment initiation. It is important to be aware of possible endocrine side effects of AEDs as they can have a major impact on quality of life, and are, at least partly, reversible after AED discontinuation.

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  • Production of SHBG is a complex process influenced by hormonal, nutritional, metabolic and pharmacologic factors.

    “Production of SHBG is a complex process that is influenced by hormonal, nutritional, metabolic and pharmacologic factors [63, 64].”

    From Role of sex hormone-binding globulin in the free hormone hypothesis and the relevance of free testosterone in androgen physiology (2022) · cites this paper as [64]

    Section 3.1 (page not supplied) states that enzyme-inducing antiepileptic drugs increase SHBG in women, supporting a pharmacologic influence on SHBG levels. Our copy does not establish that this reflects a change in SHBG production or identify hormonal, nutritional, and metabolic factors as influences on its production. (LLM, conf=0.82)

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Cited by

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Authors
Svalheim, S., Sveberg, L., Mochol, M., & Taubøll, E.
Affiliations
  • Oslo University Hospital (NO)
  • Østfold Hospital Trust (NO)
Corresponding author
Svalheim, Sigrid
ORCID
Venue
Seizure
Publisher
Elsevier BV
Published
2015-05
Volume
28
Pages
12-17
ISSN
1059-1311 (ISSN-L)
DOI
10.1016/j.seizure.2015.02.022
OpenAlex
W1992020412
Cited by
173
References
1
Citations by year
2026: 15 · 2025: 15 · 2024: 14 · 2023: 16 · 2022: 17 · 2021: 21 · 2020: 20 · 2019: 15 · 2018: 15 · 2017: 14 · 2016: 9 · 2015: 2
FWCI
2.01
Type
journal article
Language
en
Open access
Licence
Locations
  • Seizure (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmacological Effects and Toxicity Studies
  • Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Effects and risks of endocrine disrupting chemicals
Keywords
antiepileptic drugs, endocrine adverse effects, sex hormones, sex hormone-binding globulin, valproic acid, androgenization, polycystic ovary syndrome, fertility, thyroid function, bone health, lamotrigine, phenytoin, carbamazepine, phenobarbital, weight gain, menstrual irregularity, testosterone, estradiol
MeSH terms
Animals, Anticonvulsants, Endocrine System Diseases, Epilepsy, Female, Fertility, Humans, Male, Osteoporosis, Sex Hormone-Binding Globulin, Gonadal Steroid Hormones

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