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Hormone binding globulins and anticonvulsant therapy.

G H Beastall, R A Cowan, J M Gray

    Scottish Medical Journal
    |April 1, 1985
    PubMed
    Summary

    Anticonvulsant therapy significantly alters hormone binding globulins in epilepsy patients, affecting sex hormone binding globulin and cortisol binding globulin levels. These changes in hormone homeostasis may have clinical implications.

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    Area of Science:

    • Endocrinology
    • Neurology
    • Pharmacology

    Background:

    • Epilepsy treatment often involves long-term anticonvulsant therapy.
    • Anticonvulsants are known to affect various physiological processes.
    • The impact of anticonvulsants on hormone-binding globulins requires further investigation.

    Purpose of the Study:

    • To investigate the effects of long-term anticonvulsant therapy on serum binding globulin levels and bound hormones in epileptic patients.
    • To explore potential correlations between anticonvulsant drug levels and binding globulin alterations.

    Main Methods:

    • Serum levels of sex hormone binding globulin (SHBG), thyroxine binding globulin (TBG), cortisol binding globulin (CBG), and vitamin D binding globulin (VDBG) were measured.
    • Total hormone levels were determined in 21 epileptic patients on stable anticonvulsant therapy.
    • Comparisons were made with control groups, and correlations with serum phenytoin levels were analyzed.

    Main Results:

    • Elevated SHBG capacity observed in both male and female epileptic patients, correlating with phenytoin levels in females.
    • Reduced serum thyroxine and triiodothyronine levels noted, while TBG levels remained unaffected.
    • Increased CBG capacity was found, accompanied by reduced serum cortisol in women, correlating with phenytoin levels.
    • VDBG capacity and 25-hydroxycholecalciferol levels were not significantly influenced by anticonvulsants.

    Conclusions:

    • Anticonvulsant drug therapy induces significant alterations in the homeostasis of hormones and their serum binding globulins.
    • These widespread changes in hormone binding globulins may possess clinical significance in epileptic patients.
    • Further research is warranted to elucidate the clinical implications of these endocrine disruptions.

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