Abstract
Abstract Sexual dysfunction is common in patients with epilepsy, and its manifestations include hyposexuality and erectile dysfunction. The cause of this dysfunction is multifactorial and includes changes in the levels of sex hormones, the effects of antiepileptic drugs on neurotransmission, the epilepsy itself, and psychosocial factors associated with it. Traditional antiepileptic drugs, which induce the cytochrome P450 enzyme system, have the highest rates of sexual dysfunction, which is mediated by changes in sex hormone levels. In contrast newer antiepileptic drugs may cause sexual dysfunction by direct effects on neurotransmitter systems. Some antiepileptic drugs, such as oxcarbazepine and lamotrigine, may improve sexual function but can also rarely be associated with sexual dysfunction. The management of sexual dysfunction depends on its putative cause. If it is caused by antiepileptic drugs, the offending drug should be switched to alternative antiepileptic drugs that do not have a deleterious effect on sexual function. Conversely, if psychosocial factors are thought to play a role, these should be addressed in turn.
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