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Thyroid function in children with epilepsy treated with sodium valproate monotherapy: a prospective study.
Achilleas Attilakos1, Eustathia Katsarou, Alexia Prassouli
1Second Department of Pediatrics, University of Athens, Greece. attilakos@hotmail.com
Clinical Neuropharmacology
|November 4, 2008
Summary
Sodium valproate (VPA) monotherapy in children with epilepsy can alter thyroid hormone levels, decreasing thyroxine and increasing TSH. Monitoring thyroid function is recommended during VPA treatment.
Area of Science:
- Pediatric Endocrinology
- Neurology
- Clinical Pharmacology
Background:
- Epilepsy affects numerous children worldwide, with sodium valproate (VPA) being a common monotherapy.
- Previous studies on VPA's impact on thyroid function in epilepsy patients have yielded conflicting results.
- Understanding VPA's effects on thyroid hormone balance is crucial for managing pediatric epilepsy.
Purpose of the Study:
- To prospectively assess changes in thyroid hormone profiles in children with epilepsy receiving VPA monotherapy.
- To evaluate the temporal relationship between VPA treatment and thyroid function alterations.
- To determine if VPA monotherapy significantly impacts thyroxine, free thyroxine, triiodothyronine, and TSH levels.
Main Methods:
- Prospective evaluation of 30 children with epilepsy on VPA monotherapy.
- Measurement of serum thyroxine, free thyroxine, triiodothyronine, and TSH at baseline and at 6, 12, and 24 months.
- VPA serum concentrations were monitored to ensure they remained within the therapeutic range (50-100 mg/L).
Main Results:
- VPA monotherapy led to significant decreases in thyroxine and free thyroxine levels.
- Thyroid-stimulating hormone (TSH) levels significantly increased at 6, 12, and 24 months.
- Triiodothyronine levels showed a significant decrease only at 24 months, with a substantial percentage of children exhibiting elevated TSH.
- Thyroid function normalized in children after VPA withdrawal.
Conclusions:
- VPA monotherapy can induce significant thyroid profile alterations in children with epilepsy, appearing early and persisting during treatment.
- Routine monitoring of serum thyroid hormone concentrations is advisable for children with epilepsy on VPA.
- Further research is needed to elucidate the mechanisms and identify risk factors for VPA-induced thyroid disturbances in pediatric populations.
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