Details

Autor(en) / Beteiligte

• Watkins, Lance Vincent
• Angus-Leppan, Heather

Titel

Valproate, sexual health, and men: A narrative review

Ist Teil von

• Epilepsy & behavior, 2020-02, Vol.103 (Pt A), p.106835-106835, Article 106835

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2020

Quelle

Elsevier ScienceDirect Journals

Beschreibungen/Notizen

• This article explores current evidence about the effects of valproate (VPA) medicines on sexual health in men, how to monitor symptoms, communicate with patients, and improve clinical outcomes. There has been a lot of focus on VPA use in women of childbearing age following recent changes to prescribing regulations owing to the well-established and significant teratogenic risk. Concerns have been raised by patients and clinicians as to the risk of adverse sexual effects of VPA use in men. The evidence base for the effect of VPA on sexual function compared with other antiepileptic drugs (AEDs) in men is limited with no randomized controlled trials. Sexual function in men with epilepsy is complex, and there is no direct relationship between objective measures of sexual function and sexual satisfaction. Epilepsy, comorbidities, psychosocial factors, and most AEDs including VPA may cause sexual dysfunction in men, including reduced sexual desire, erectile dysfunction, and fertility problems. Sexual and reproductive function should be discussed with men prior to treatment with AEDs including VPA. Early and proactive discussion of sexual and reproductive functioning mitigates, rather than increases, the risk of sexual problems and potentially improves adherence. Sexual dysfunction in men with cognitive impairment [such as intellectual disability (ID) and dementia] may present with behavioral disturbance. Identification of sexual adverse effects of medication could significantly change treatment plans which is of particular importance for individuals with treatment resistance. We provide an information fact sheet for men to help guide prescribing discussions. •Sexual function in men with epilepsy is complex, there is no direct relationship between measures of sexual function and sexual satisfaction•Epilepsy, co-morbidities, psychosocial factors and most AEDs including VPA may cause sexual dysfunction in men.•The evidence base for the effect of VPA on sexual function in men is limited with no randomised controlled trials.•Pro-active discussion of sexual and reproductive functioning mitigates, rather than increases the risk of sexual problems.•Identification of sexual side effects in men with cognitive impairment could significantly change treatment plans.