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I know that divalproex sodium can increase shbg, thereby reducing free testosterone, but does it have any effect on total t in men?

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You are correct.
Most of the anti-epileptic drugs (aeds) increase shbg and reduce free t. Even though aeds may raise total t levels because of this effect on shbg, the total t levels almost always remain within the wide normal range for total t (~300-1100 ng/dl) depending on the reference range used by a given lab. Free t and albumin-bound t (bioavailable t) are the active forms of t in the body.

In brief: See answer

You are correct.
Most of the anti-epileptic drugs (aeds) increase shbg and reduce free t. Even though aeds may raise total t levels because of this effect on shbg, the total t levels almost always remain within the wide normal range for total t (~300-1100 ng/dl) depending on the reference range used by a given lab. Free t and albumin-bound t (bioavailable t) are the active forms of t in the body.
Dr. Gregory Lewis
Dr. Gregory Lewis
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