Reversible effects of antiepileptic drugs on thyroid hormones in men and women with epilepsy: a prospective randomized double-blind withdrawal study.
Antiepileptic drugs (AEDs) may affect serum thyroid hormone concentrations. This prospective, randomized study evaluated thyroid function in men and women with epilepsy both before and after double-blinded withdrawal of AED monotherapy, and assessed whether any changes were reversible. One hundred sixty patients were randomized to withdrawal and nonwithdrawal groups; 150 patients completed the intervention and were included in the 12-month study. Serum samples were obtained from 130 patients, from before and 4 months after intervention. Following AED withdrawal, significant increases in free thyroxine (FT(4)) serum concentrations were measured in men and women treated with carbamazepine. In women treated with valproate, serum concentrations of free triiodothyronine (FT(3)) decreased significantly in the withdrawal group. Thus, for both men and women with epilepsy, carbamazepine treatment reduces serum FT(4) concentrations, but valproate treatment of women with epilepsy increases serum FT(3.) Our study demonstrated that these changes can be reversed by treatment withdrawal, even after years of treatment.
Lossius
Morten I
MI
National Centre for Epilepsy, Division of Clinical Neuroscience, Rikshospitalet University Hospital, Oslo, Norway. Morten.lossius@epilepsy.no
Taubøll
Erik
E
Mowinckel
Petter
P
Gjerstad
Leif
L
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D002220:Carbamazepine / Q000009:adverse effects / Q000627:therapeutic use; D004311:Double-Blind Method; D004827:Epilepsy / Q000097:blood* / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012727:Sex Characteristics; D013375:Substance Withdrawal Syndrome / Q000503:physiopathology; D013960:Thyroid Function Tests; D013963:Thyroid Hormones / Q000097:blood*; D014635:Valproic Acid / Q000009:adverse effects / Q000627:therapeutic use; D055815:Young Adult
D000927:Anticonvulsants; D013963:Thyroid Hormones; D002220:Carbamazepine; D014635:Valproic Acid