Vaproate associated reproductive and sexual dysfunctions: are epileptic men at greater risk than bipolar men?

  • Ass Prof Fisun Akdeniz, Ege University, School of Medicine, Department of Psychiatry, Turkey
  • Ebru Aldemir, Ege University, School of Medicine, Department of Psychiatry, Turkey
  • Prof Baris Altay, Ege University, School of Medicine, Department of Urology, Turkey
  • Sehnaz Arici, Ataturk State Hospital, 2. Neurology Unit, Turkey
  • Ass Prof Mehmet Celebisoy, Ataturk State Hospital, 2. Neurology Unit, Turkey
  • Prof Simavi Vahip, Ege University, Turkey

Evidence indicates that valproate (VPA) may have an adverse impact on reproductive endocrine and sexual functions in men with epilepsy.
This study explores whether the association of VPA with reproductive endocrine abnormalities is applicable to men with bipolar disorder (BD) or is unique to men with epilepsy.
Thirty-nine male patients aged 18–50 years with a DSM-IV diagnosis of BD (21 on lithium monotherapy and 18 on VPA monotherapy or VPA in combination with lithium therapy) and 15 with idiopathic generalized epilepsy (IGE) on VPA monotherapy were evaluated for reproductive endocrine (reproductive hormones, sperm parameters) and sexual functioning (evaluated with International Inventroy of Erectile Function).
There were no difference between study groups on reproductive endocrine parameters (E2, LH, FSH, SHBG, free-T). Serum prolactine levels were higher among epileptic patients. The sperm count, motility and morphology were not significantly different between groups. The erectile function, sexual desire and intercourse satisfaction scores were not different between groups, but the orgasmic function score was lower in epileptic patients.
In this study, we have showed that VPA has no negative impact on male reproductive and sexual functions. This is the first study in the literature that compares the reproductive and sexual functions between patients on VPA for BD and epilepsy.