title: Effects of antiepileptic drug on thyroid hormones in patients with epilepsy: A meta-analysis.
abstract: OBJECTIVE
  As antiepileptic drugs (AEDs) are known to be associated with alterations in thyroid profiles, we aimed to carry out a meta-analysis to comprehensively assess the effects of AEDs on thyroid hormones in patients with epilepsy.
  
  
  METHODS
  We searched the NCBI (PubMed), ISI Web of Science, EMBASE databases, and Cochrane Library to identify studies evaluating the association between AED use and thyroid hormone profiles in patients with epilepsy. Fixed or random effects meta-analysis was used to pool results across studies.
  
  
  RESULTS
  In all, 35 studies were included in our analysis. Out of a total of 997 patients in these studies, epileptic patients receiving AEDs showed an overall significant decrease in thyroxin (T4) and free T4 (fT4) and higher levels of thyroid stimulating hormone (TSH) than the controls (T4: standardized mean difference [SMD]=-1.839, 95% confidence interval [CI], -2.063 to -1.614; fT4: SMD=-1.190, 95% CI, -1.687 to -0.692; TSH: SMD=0.445, 95% CI, 0.031-0.858). Notably, the use of carbamazepine (CBZ) suggested a significant decrease in triiodothyronine (T3), T4, and fT4; phenytoin (PHT) use showed a decrease in T4 and fT4; and valproic acid (VPA) use was associated with decreased T4 and increased TSH.
  
  
  CONCLUSIONS
  Our study suggests that use of AEDs such as CBZ, PHT, and VPA, was associated with alteration of thyroid hormones among patients with epilepsy.
authors.affiliation: Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88, Jiefang Road, Hangzhou 310009, China.
authors.forename: Yin-Xi
authors.initials: YX
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88, Jiefang Road, Hangzhou 310009, China.
authors.forename: Chun-Hong
authors.initials: CH
authors.lastname: Shen
authors.affiliation: Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88, Jiefang Road, Hangzhou 310009, China.
authors.forename: Qi-Lun
authors.initials: QL
authors.lastname: Lai
authors.affiliation: Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88, Jiefang Road, Hangzhou 310009, China.
authors.forename: Gao-Li
authors.initials: GL
authors.lastname: Fang
authors.affiliation: Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88, Jiefang Road, Hangzhou 310009, China.
authors.forename: Wen-Jie
authors.initials: WJ
authors.lastname: Ming
authors.affiliation: Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88, Jiefang Road, Hangzhou 310009, China.
authors.forename: Ru-Yi
authors.initials: RY
authors.lastname: Lu
authors.affiliation: Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88, Jiefang Road, Hangzhou 310009, China. Electronic address: meipingd@163.com.
authors.forename: Mei-Ping
authors.initials: MP
authors.lastname: Ding
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use*; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D004827:Epilepsy / Q000188:drug therapy* / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D013960:Thyroid Function Tests; D013963:Thyroid Hormones / Q000378:metabolism*; D013972:Thyrotropin / Q000378:metabolism; D013974:Thyroxine / Q000378:metabolism; D014284:Triiodothyronine / Q000378:metabolism
chemical_list: D000927:Anticonvulsants; D013963:Thyroid Hormones; D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine
keywords: Antiepileptic drugs; Meta-analysis; Thyroid hormones