title: Thyroid hormone levels in children receiving carbamazepine or valproate.
abstract: Antiepileptic therapy is associated with alteration of thyroid hormone levels. We evaluated the effect of valproate and carbamazepine therapy on the thyroid hormone profile of epileptic children. Subjects included children aged 2-12 years receiving therapy for at least 6 months. Free triiodothyronine, free thyroxine, and thyroid-stimulating hormone were measured by electrochemiluminescent assay in 30 children receiving carbamazepine, 34 children receiving valproate, and 30 age- and sex-matched control subjects. Groups were similar for age, body mass index, and duration of therapy. Thyroid-stimulating hormone (mean ± S.D.) was 2.67 ± 1.66, 4.53 ± 1.9, and 3.61 ± 1.75 μ IU/mL in the control, valproate, and carbamazepine group, respectively (P < 0.001). Free thyroxine was 1.39 ± 0.19, 1.40 ± 0.63, 1.11 ± 0.19 ng/dL (P = 0.009). Free triiodothyronine was 4.03 ± 0.74, 4.14 ± 0.94, 3.92 ± 0.68 pg/mL (P = 0.54). When groups were compared 2 at a time, there was no difference in free triiodothyronine (P > 0.05). Free thyroxine levels in the carbamazepine group were significantly different from valproate (P = 0.015) and control (P = 0.027). Thyroid-stimulating hormone increased with both valproate and carbamazepine compared to control but was significant with valproate (P < 0.001). We conclude that carbamazepine and valproate therapy alters thyroid functions by decreasing free thyroxine levels. Compensation by increase in thyroid-stimulating hormone is better with valproate. The need for monitoring and supplementation should be assessed further.
authors.affiliation: Department of Pediatrics, University College of Medical Sciences and Guru Tegh Bahadur Hospital, New Delhi, India. aanju67@gmail.com
authors.forename: Anju
authors.initials: A
authors.lastname: Aggarwal
authors.forename: Neha
authors.initials: N
authors.lastname: Rastogi
authors.forename: Hema
authors.initials: H
authors.lastname: Mittal
authors.forename: Neelam
authors.initials: N
authors.lastname: Chillar
authors.forename: Rahul
authors.initials: R
authors.lastname: Patil
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D002220:Carbamazepine / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D004563:Electrochemistry; D004828:Epilepsies, Partial / Q000097:blood / Q000188:drug therapy; D004829:Epilepsy, Generalized / Q000097:blood / Q000188:drug therapy; D005260:Female; D006801:Humans; D049449:Luminescence; D008297:Male; D012016:Reference Values; D018401:Sample Size; D013963:Thyroid Hormones / Q000097:blood*; D014635:Valproic Acid / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D013963:Thyroid Hormones; D002220:Carbamazepine; D014635:Valproic Acid