MIDDLE EAST JOURNAL OF FAMILY MEDICINE • VOLUME 7, ISSUE 10  MIDDLE EAST JOURNAL OF FAMILY MEDICINE VOLUME 8 ISSUE 10 ORIGINAL CONTRIBUTION AND CLINICAL INVESTIGATION MIDDLE EAST JOURNAL OF PSYCHIATRY AND ALZHEIMERS, VOLUME 4 ISSUE 2 COMMUNITY PSYCHIATRY Epilepsy, Antiepileptic Drugs and Depression: A Triangle of Danger for Sexual and Reproductive Functions in Females Khalid Sallam (1) Mahmoud Abosrie (1) Abd Al-Nasir Murad (2) Mostafa Amr (2) (1) Departments of Neurology, Obstetrics & Gynecology, Faculty of Medicine, Benha University, Egypt (2) Department of Psychiatry, Mansoura University, Egypt Correspondence: Dr. Mostafa Amr Department of Psychiatry, Mansoura University, Egypt Email: mostafapsy@yahoo.com Abstract Objectives: To explore the relationship between epilepsy and anti-epileptic drug (AED) and sexual, reproductive and psychological functions of epileptic women. Patients & Methods: The study included 60 women with partial seizures of temporal lobe origin (TLE) and 20 control age- matched women. All women underwent full history taking and sexual interest and function during the preceding week, measured using the Arizona Sexual Experience Scale (ASEX) questionnaire and were evaluated in terms of possible presence of depression using the Beck Depression Inventory (BDI). Fasting, morning blood samples were obtained for estimation of hormonal proile including serum total testosterone, estradiol (E2), sex hormone-binding globulin (SHBG), leutinizing hormone (LH) and follicle stimulating hormone (FSH). Results: Epileptic women were overweight to obese; 23 were infertile and 47 women had irregular menstrual cycle. Epileptic women had signiicantly higher serum testosterone and SHBG with signiicantly lower serum E2 compared to control women. Twenty-three women had right TLE and 16 patients had stopped AED at least 3 months before testing. Mean ASEX score in epileptics was signiicantly higher compared to controls with signiicantly higher mean ASEX score in epileptics who had right TLE compared to those who had left TLE and in those on AED compared to those who stopped treatment. Mean BDI score in epileptics was signiicantly higher compared to controls, with signiicantly higher mean BDI score in epileptics who had right TLE compared to those who had left TLE, but patients maintained on AED showed non-signiicantly higher BDI score compared to those who stopped AED. There was a positive signiicant correlation between presence of TLE and high ASEX scores, BDI scores, serum testosterone and serum SHBG, but showed a negative signiicant correlation with serum E2. Regression analysis showed low serum E2 and presence of epilepsy as the signiicant predictors for high ASEX score which was the most signiicant predictor for high BDI score. Conclusion: Epilepsy has deleterious effects on psychological, sexual and reproductive functions in women and such effect was magniied with AED and with lesions on the right side and showed a close relationship to disturbed sex hormone levels. Key words: Females, Epilepsy, Antiepileptic drugs, Depression, Sexual and Reproductive functions