Isojärvi J I, Repo M, Pakarinen A J, Lukkarinen O, Myllylä V V
Department of Neurology, University of Oulu, Finland.
Epilepsia. 1995 Apr;36(4):366-70. doi: 10.1111/j.1528-1157.1995.tb01011.x.
We evaluated the effects of carbamazepine (CBZ) on serum androgen levels and sexual function prospectively for 5 years in 11 men with epilepsy and in 25 patients receiving either CBZ (14 patients) or phenytoin (PHT) (11) monotherapy for > 5 years. Serum sex hormone binding globulin (SHBG) levels increased and free androgen index (FAI) decreased during CBZ treatment, and these changes correlated with duration of CBZ therapy. Similarly, serum SHBG levels increased and FAI values decreased in patients receiving PHT for > 5 years. CBZ and PHT increase serum SHBG levels, leading to decreased FAI. These drug-related hormonal changes may be the primary cause of hyposexuality common in men with epilepsy.
我们对11名癫痫男性患者以及25名接受卡马西平（CBZ）（14例）或苯妥英钠（PHT）（11例）单药治疗超过5年的患者进行了为期5年的前瞻性评估，以观察卡马西平对血清雄激素水平和性功能的影响。在卡马西平治疗期间，血清性激素结合球蛋白（SHBG）水平升高，游离雄激素指数（FAI）降低，且这些变化与卡马西平治疗持续时间相关。同样，接受苯妥英钠治疗超过5年的患者血清SHBG水平升高，FAI值降低。卡马西平和苯妥英钠均会使血清SHBG水平升高，导致FAI降低。这些与药物相关的激素变化可能是癫痫男性中常见的性欲减退的主要原因。
