topiramate and Erectile-Dysfunction

Sexual pharmacotoxicity renders patients with epilepsy at a risk for sexual dysfunction (SD). This study is aimed to analyze the relationship between sexual function and topiramate to avoid topiramate-associated SD.. A systematic review following the PRISMA guidelines was performed to elucidate any SD occurrence in patients receiving topiramate.. A total of 17 publications were reviewed. Based on limited polytherapy observational studies, the frequency of self-reported topiramate-associated SD, libido disorder, and orgasmic disorder in patients with polytherapy was 9.0%, 9.0%, and 2.6%, respectively (grade C evidence). Female patients mainly had anorgasmia, whereas male patients principally had erectile dysfunction. The daily dose of topiramate in patients with SD was within the recommended dose. Sexual adversity usually occurred from 4weeks after topiramate use but favorably subsided without eventful complications after topiramate substitution or dose reduction in all patients.. Topiramate can elicit different patterns of SD, especially anorgasmia in women and erectile dysfunction in men, even with a therapeutic dose. Detailed drug education and careful monitoring are necessary to maximize sexual health, especially in persons undergoing polytherapy and with other risks for SD. Moreover, a rapid response, such as substitution or reduction of the dose, is suggested when SD occurs during its use.

Topics: Adult; Anticonvulsants; Epilepsy; Erectile Dysfunction; Female; Fructose; Humans; Libido; Male; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Topiramate

Topiramate (TPM) is a newer antiepileptic drug with high efficacy in treating various neurological disorders, especially epilepsy and migraine. The adverse effects of TPM therapy are mainly central nervous system-related somnolence and dizziness. There are rare reports about the role of TPM on sexual effects, but with inconsistent results. In this report, we describe a 31-year-old man who developed erectile dysfunction after several months of TPM use. Complete urological and sexual psychiatric evaluations were done. There was lack of an identifiable organic basis and psychiatric pathology in this patient. The erectile dysfunction improved only after the termination of TPM, documenting the temporal relationship. We reviewed and discussed the clinical aspect of TPM use in erectile dysfunction. This case and the rare cases of erectile dysfunction in TPM use reported in the literature show that TPM is worth to be paid attention to whenever it is prescribed in a wide range of neurological disorders.

Topics: Adult; Anticonvulsants; Epilepsy, Temporal Lobe; Erectile Dysfunction; Fructose; Humans; Male; Topiramate

Described here is a case of topiramate-induced reversible erectile dysfunction in which possible pathogenetic mechanisms were excluded by use of appropriate psychological, neurophysiological, ultrasound, and laboratory tests.

Topics: Anticonvulsants; Electroencephalography; Epilepsy, Frontal Lobe; Erectile Dysfunction; Fructose; Gonadal Steroid Hormones; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Topiramate; Ultrasonography

Topics: Adult; Anticonvulsants; Epilepsy; Epilepsy, Frontal Lobe; Epilepsy, Temporal Lobe; Erectile Dysfunction; Fructose; Humans; Male; Topiramate

Topics: Adult; Anticonvulsants; Carbonic Anhydrase Inhibitors; Chronic Disease; Dose-Response Relationship, Drug; Erectile Dysfunction; Female; Fructose; Humans; Male; Middle Aged; Migraine Disorders; Nitric Oxide; Penile Erection; Regional Blood Flow; Sex Characteristics; Sexual Dysfunction, Physiological; Topiramate