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Had minor accident and getting seizures. Taking Zonisamide. Having erectile dysfunction problems. Is it due to side effect?

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Addiction Medicine Specialist
Practicing since : 2002
Answered : 1486 Questions
I am an 81 year old male in very good health for my age. I don't drink alcohol as I never liked it, and I quit smoking 55 years ago. I have been walking 3 miles first thing every morning for the last 10 years. I still ride my 2001 Honda Goldwing Motorcycle that I have ridden 145,000 miles. About 1 1/2 years ago I was in a minor motorcycle accident where my brakes failed and I wound up with getting occasional seizures. I was first put on Lamictal, which didn't seem to agree with me. Then I was switched to Zonisamide, 200mg/day. Ever since these medications I have been having E.D. problems. Is there possibly any side effects from the Zonisamide that might cause this?
Posted Tue, 17 Sep 2013 in Epilepsy
Answered by Dr. Preeti Parakh 1 hour later
Brief Answer:
Yes, Zonisamide may cause erectile dysfunction.

Detailed Answer:

Welcome to HealthCare Magic!

It is nice to know that you have maintained yourself so well and are in such good health.

Regarding your query, zonisamide is well known to cause erectile dysfunction as an adverse effect. If your erectile dysfunction started after you were put on antiepileptic drugs, it is quite likely that the erectile dysfunction is drug-induced.

I usually manage this problem in the following ways:

1) I find that changing the anti-epileptic agent usually works. The best possible alternative is oxcarbazepine, though other anti-epileptic drugs like valproate also may be tried. Oxcarbazepine has been shown to have a positive effect on anti-epileptic induced male sexual dysfunction. So, if your doctor concurs with this, you can go for a trial of oxcarbazepine.

2) If a change of anti-epileptic drug is not possible or doesn't work, then I usually ask for a blood test for hormonal levels and advise androgen (testosterone) therapy if required.

3) In case the first two options do not work, there is also another option of using agents like sildenafil or tadalafil to counter the erectile dysfunction.

In addition, I also assess if there are any other possible causes for erectile dysfunction, like anxiety and stress and treat them as indicated.

Last but not the least, zonisamide induced erectile dysfunction is known to be reversible on stopping the drug. Hence, you need not worry at all.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health,

Dr Preeti Parakh
MD Psychiatry
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