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Evaluation of thyroid hormones in children receiving carbamazepine or valproate: a prospective study

İhsan Kafadar1, Betül Aydın Kılıç2, Mujde Arapoglu3

  • 1Department of Pediatrics, Division of Pediatric Neurology, Sisli Etfal Training & Research Hospital, Istanbul, Turkey.

Journal of Child Neurology
|April 17, 2014
PubMed

Insights

Carbamazepine monotherapy in children significantly lowers thyroid hormone levels, but not thyroid-stimulating hormone, without causing clinical symptoms. Valproate monotherapy did not alter thyroid hormones but increased thyroid-stimulating hormone at 12 months.

Area of Science:

  • Pediatric Endocrinology
  • Neuropharmacology
  • Clinical Chemistry

Background:

  • Epilepsy affects a significant pediatric population.
  • Antiepileptic drugs (AEDs) like carbamazepine and valproate are common treatments.
  • Potential endocrine side effects of AEDs require thorough investigation.

Purpose of the Study:

  • To prospectively evaluate thyroid function alterations in pediatric patients undergoing monotherapy with carbamazepine or valproate.
  • To compare thyroid hormone levels and thyroid-stimulating hormone between AED-treated groups and a control group.

Main Methods:

  • Prospective study design.
  • Inclusion of 40 valproate-treated, 33 carbamazepine-treated, and 36 control pediatric patients (ages 2-18).
  • Measurement of serum thyroid hormones at baseline, 6 months, and 12 months of AED treatment.

Main Results:

  • Carbamazepine treatment led to significantly lower mean serum thyroid hormone levels compared to baseline and controls.
  • No significant changes in thyroid-stimulating hormone were observed at 6 or 12 months in carbamazepine-treated patients.
  • Valproate treatment did not alter serum hormone levels, but significantly increased thyroid-stimulating hormone at 12 months.

Conclusions:

  • Carbamazepine monotherapy induces significant changes in thyroid hormone levels in pediatric patients.
  • Despite thyroid hormone alterations, carbamazepine did not result in clinical symptoms within the 12-month follow-up.
  • Valproate monotherapy may impact thyroid-stimulating hormone levels in children over time.

Keywords:
carbamazepinechildrenepilepsythyroid functionsvalproate

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