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癫痫与抗癫痫药物:内分泌干扰的“秘密特工”

Epilepsy and Anti-Seizure Medications: Secret Agents for Endocrine Disruption.

作者信息

Sazgar Mona, Mnatsakanyan Lilit, Pack Alison M, Harden Cynthia L

机构信息

Department of Neurology, University of California, Irvine CA, USA.

Department of Neurology, Columbia University, New York, NY, USA.

出版信息

Epilepsy Curr. 2023 Dec 6;24(2):79-83. doi: 10.1177/15357597231213248. eCollection 2024 Mar-Apr.

Abstract

There is a reciprocal relationship between epilepsy and reproductive endocrine disorders. Seizures and anti-seizure medications (ASMs) can contribute to reproductive and endocrine dysfunction and reproductive dysfunction may exacerbate seizures. Epilepsy via neuroendocrine mechanisms affects the hypothalamic-pituitary-ovarian (HPO) axis, disrupting the regulation of gonadotropin secretion, and resulting in dystrophic effects on the ovaries and early menopause. Anti-seizure medications have endocrine-related side effects on sexual function and bone health. Long-term use of ASMs may result in menstrual irregularities, sexual dysfunction, anovulatory cycles, polycystic ovaries, and reduced fertility. Some ASMs also interfere with bone metabolism. Epilepsy patients treated with ASMs are at risk for bone loss and fractures. This article explores the endocrine and hormonal effects of seizures and ASMs.

摘要

癫痫与生殖内分泌紊乱之间存在相互关系。癫痫发作和抗癫痫药物(ASMs)可导致生殖和内分泌功能障碍,而生殖功能障碍可能会加重癫痫发作。癫痫通过神经内分泌机制影响下丘脑-垂体-卵巢(HPO)轴,扰乱促性腺激素分泌的调节,对卵巢产生营养不良影响并导致过早绝经。抗癫痫药物对性功能和骨骼健康有与内分泌相关的副作用。长期使用抗癫痫药物可能导致月经不调、性功能障碍、无排卵周期、多囊卵巢以及生育能力下降。一些抗癫痫药物还会干扰骨代谢。接受抗癫痫药物治疗的癫痫患者有骨质流失和骨折的风险。本文探讨癫痫发作和抗癫痫药物的内分泌及激素影响。

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