FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W1995061115> ?p ?o ?g. }

• W1995061115 endingPage "167" @default.
• W1995061115 startingPage "166" @default.
• W1995061115 abstract "The antiepileptic drug (AED) topiramate (TPM) is efficient in new-onset partial epilepsies (1) as well as in refractory partial and generalized epilepsies (2). Several adverse events with this substance have been described; the most common and important include somnolence, fatigue, nausea, anorexia and weight loss, paresthesias, psychomotor slowing and confusion, dizziness, and headache (2). Interference with sexual function with TPM has, to our knowledge, not yet been reported. We recently encountered two patients with partial epilepsy in whom reversible erectile dysfunction developed while taking TPM. We describe the cases to draw attention to a distressing side effect of the drug. A 37-year-old patient with cryptogenic frontal lobe epilepsy since age 24 years had three to four complex partial seizures per month with rare secondary generalization. The clinical and EEG features indicated that the seizures originated from the right frontal lobe, but no structural lesion could be identified. The attacks were refractory to 1,200 mg carbamazepine (CBZ) and 900 mg valproic acid (VPA), daily. Thus TPM was added to these drugs. The dosage was increased by 25 mg/week up to 200 mg daily, and the frequency of complex partial seizures decreased to one to two per month. Two weeks after the maximal dosage had been reached, the patient complained about erectile dysfunction leaving him incapable of having sexual intercourse. No reduction in libido or subjective sexual arousal occurred. Such a problem had previously been completely unknown to the patient. Apart from the AEDs, the patient did not take any further medication. Hepatic and renal functions were entirely normal. In a first step, TPM dosage was decreased to 100 mg daily, but this had no beneficial effect on erectile dysfunction. After termination of TPM, sexual function was completely restored within a month. A 43-year-old patient had cryptogenic temporal lobe epilepsy with two to three complex partial seizures per month and a total of two secondarily generalized tonic–clonic seizures for 2 years. Based on clinical and EEG features, no lateralization of seizure onset was possible, and no structural lesion could be identified on neuroimaging studies. After failure or intolerable side effects of CBZ, oxcarbazepine (OXC), and gabapentin (GBP), the patient was included in a multicenter randomized open trial comparing monotherapy with TPM and VPA. The patient was randomized on TPM, and in line with the study protocol, the dosage was increased by 25 mg/week to 100 mg daily. With this regimen, the seizure frequency was reduced to one to two complex partial seizures per month. One week after treatment with TPM had been started, the patient complained about paresthesias of the distal upper and lower extremities. Four weeks after the maximal dosage was reached, the patient reported erectile dysfunction that impaired sexual intercourse. Libido and subjective sexual arousal were not affected. The patient had never experienced a similar problem. Apart from TPM, he did not take any other medication. Clinically, no features indicated renal or hepatic dysfunction, although biochemical testing revealed slight elevation of alanine aminotransferase of 53 U/L (reference value, <45 U/L) and mild increase of lactate dehydrogenase of 263 U/L (reference value, <248 U/L). Dosage reduction of TPM to 75 mg daily did not improve sexual dysfunction; however, termination of the drug resulted in normal sexual function within 2 weeks. Sexual dysfunctions have been described with well-established AEDs such as CBZ, Phenobarbital (PB), phenytoin (PHT), and primidone (PRM) in ∼11–22% of cases (3); however, this has not yet been reported under “new” substances. Of ∼40 patients with partial seizures that we have treated so far in our clinic with TPM, only the two patients of this report had reversible erectile dysfunction, but this does not allow general conclusions regarding the frequency of this adverse event. In both patients, onset and termination of erectile dysfunction correlated closely with the exposition to TPM, making a causal relation likely. Interestingly, reduction of the dosage did not result in any improvement of sexual functions, and termination of TPM was required to resolve this side effect. CBZ has been shown to decrease significantly the levels of the testosterone precursor dehydroepiandrosterone, whereas the levels of sex hormone–binding globulin are increased (4,5). Both effects result from induction of the hepatic enzyme P-450 by CBZ and other conventional AEDs (6). Hepatic enzyme induction causes an accelerated metabolism of sexual hormones and a stimulated production of binding hormones, both of which decrease free, bioactive testosterone and may serve as an explanation for sexual dysfunction (7). Although the levels of steroid contraceptives have been shown not to decrease with TPM in dosages up to 200 mg daily (8), the substance does induce cytochrome P-450 in human hepatocytes (9). Thus erectile dysfunction with TPM also may be explained by low levels of free testosterone after increased hepatic metabolism. The two current cases indicate that erectile dysfunction should be considered as part of the spectrum of reversible adverse events in patients treated with TPM." @default.
• W1995061115 created "2016-06-24" @default.
• W1995061115 creator A5028867235 @default.
• W1995061115 creator A5044608522 @default.
• W1995061115 creator A5071995676 @default.
• W1995061115 date "2005-01-01" @default.
• W1995061115 modified "2023-10-03" @default.
• W1995061115 title "Erectile Dysfunction with Topiramate" @default.
• W1995061115 cites W1974269801 @default.
• W1995061115 cites W2033614870 @default.
• W1995061115 cites W2049772989 @default.
• W1995061115 cites W2069765786 @default.
• W1995061115 cites W2119302703 @default.
• W1995061115 cites W2134306772 @default.
• W1995061115 cites W2139219940 @default.
• W1995061115 cites W2320058521 @default.
• W1995061115 cites W4233356841 @default.
• W1995061115 doi "https://doi.org/10.1111/j.0013-9580.2005.41504.x" @default.
• W1995061115 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/15660786" @default.
• W1995061115 hasPublicationYear "2005" @default.
• W1995061115 type Work @default.
• W1995061115 sameAs 1995061115 @default.
• W1995061115 citedByCount "32" @default.
• W1995061115 countsByYear W19950611152012 @default.
• W1995061115 countsByYear W19950611152013 @default.
• W1995061115 countsByYear W19950611152014 @default.
• W1995061115 countsByYear W19950611152015 @default.
• W1995061115 countsByYear W19950611152016 @default.
• W1995061115 countsByYear W19950611152017 @default.
• W1995061115 crossrefType "journal-article" @default.
• W1995061115 hasAuthorship W1995061115A5028867235 @default.
• W1995061115 hasAuthorship W1995061115A5044608522 @default.
• W1995061115 hasAuthorship W1995061115A5071995676 @default.
• W1995061115 hasBestOaLocation W19950611151 @default.
• W1995061115 hasConcept C118552586 @default.
• W1995061115 hasConcept C126322002 @default.
• W1995061115 hasConcept C15744967 @default.
• W1995061115 hasConcept C187212893 @default.
• W1995061115 hasConcept C197934379 @default.
• W1995061115 hasConcept C2777172819 @default.
• W1995061115 hasConcept C2777332695 @default.
• W1995061115 hasConcept C2777683783 @default.
• W1995061115 hasConcept C2778093883 @default.
• W1995061115 hasConcept C2778186239 @default.
• W1995061115 hasConcept C2779034229 @default.
• W1995061115 hasConcept C2779088608 @default.
• W1995061115 hasConcept C2779134260 @default.
• W1995061115 hasConcept C2779253243 @default.
• W1995061115 hasConcept C2779366285 @default.
• W1995061115 hasConcept C2779929075 @default.
• W1995061115 hasConcept C2779979230 @default.
• W1995061115 hasConcept C42219234 @default.
• W1995061115 hasConcept C71924100 @default.
• W1995061115 hasConceptScore W1995061115C118552586 @default.
• W1995061115 hasConceptScore W1995061115C126322002 @default.
• W1995061115 hasConceptScore W1995061115C15744967 @default.
• W1995061115 hasConceptScore W1995061115C187212893 @default.
• W1995061115 hasConceptScore W1995061115C197934379 @default.
• W1995061115 hasConceptScore W1995061115C2777172819 @default.
• W1995061115 hasConceptScore W1995061115C2777332695 @default.
• W1995061115 hasConceptScore W1995061115C2777683783 @default.
• W1995061115 hasConceptScore W1995061115C2778093883 @default.
• W1995061115 hasConceptScore W1995061115C2778186239 @default.
• W1995061115 hasConceptScore W1995061115C2779034229 @default.
• W1995061115 hasConceptScore W1995061115C2779088608 @default.
• W1995061115 hasConceptScore W1995061115C2779134260 @default.
• W1995061115 hasConceptScore W1995061115C2779253243 @default.
• W1995061115 hasConceptScore W1995061115C2779366285 @default.
• W1995061115 hasConceptScore W1995061115C2779929075 @default.
• W1995061115 hasConceptScore W1995061115C2779979230 @default.
• W1995061115 hasConceptScore W1995061115C42219234 @default.
• W1995061115 hasConceptScore W1995061115C71924100 @default.
• W1995061115 hasIssue "1" @default.
• W1995061115 hasLocation W19950611151 @default.
• W1995061115 hasLocation W19950611152 @default.
• W1995061115 hasOpenAccess W1995061115 @default.
• W1995061115 hasPrimaryLocation W19950611151 @default.
• W1995061115 hasRelatedWork W1658899326 @default.
• W1995061115 hasRelatedWork W1999498747 @default.
• W1995061115 hasRelatedWork W2016175501 @default.
• W1995061115 hasRelatedWork W2565914894 @default.
• W1995061115 hasRelatedWork W2808840749 @default.
• W1995061115 hasRelatedWork W3188605494 @default.
• W1995061115 hasRelatedWork W4253412250 @default.
• W1995061115 hasRelatedWork W4283158054 @default.
• W1995061115 hasRelatedWork W2181372206 @default.
• W1995061115 hasRelatedWork W2549955901 @default.
• W1995061115 hasVolume "46" @default.
• W1995061115 isParatext "false" @default.
• W1995061115 isRetracted "false" @default.
• W1995061115 magId "1995061115" @default.
• W1995061115 workType "article" @default.