The effect of phenytoin and carbamazepine on serum dehydroepiandrosterone sulfate in men and women who have partial seizures with temporal lobe involvement.

In a study of 16 men and 55 women with temporal lobe epilepsy (TLE), we found that the serum dehydroepiandrosterone sulfate (DHEA-S) level was significantly lower (P less than 0.05) in patients who were treated with phenytoin (mean +/- SD DHEA-S in men, 685 +/- 429 ng/ml; in women, 580 +/- 289), carbamazepine (women, 779 +/- 529), or a combination of the two drugs (men, 491 +/- 246; women, 474 +/- 284) than in age- and sex-matched untreated patients (men, 2634 +/- 418; women, 2011 +/- 1435) or in normal subjects (men, 2870 +/- 1052; women, 1764 +/- 617). DHEA-S values in the treated groups did not differ from one another. The DHEA-S levels in untreated patients with TLE did not differ significantly from those in normal subjects. TLE alone, therefore, is unlikely to account for the decrease in DHEA-S, and thus, the results suggest that the antiseizure medications are capable of reducing DHEA-S levels. These findings are important because DHEA-S levels are often measured as part of a battery of tests to assess endocrine function in conditions such as polycystic ovarian syndrome, which may be over-represented among women with TLE.