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Anticonvulsants and thyroid function.

P P Yeo, D Bates, J G Howe

    British Medical Journal
    |June 17, 1978
    PubMed
    Summary
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    Anticonvulsant medications like phenytoin significantly lower thyroid hormone levels (TT4, FT4, FT3) in epilepsy patients, suggesting increased hormone clearance. These findings highlight potential thyroid function impacts in epilepsy treatment.

    Area of Science:

    • Endocrinology
    • Clinical Pharmacology
    • Neurology

    Background:

    • Epilepsy is a common neurological disorder.
    • Anticonvulsant drugs are the primary treatment for epilepsy.
    • Thyroid hormone levels can be affected by various medications.

    Purpose of the Study:

    • To investigate the impact of anticonvulsant therapy on serum total and free thyroid hormone concentrations in epilepsy patients.
    • To compare thyroid hormone levels in patients taking anticonvulsants versus controls.
    • To analyze the specific effects of phenytoin, phenobarbitone, and carbamazepine on thyroid hormones.

    Main Methods:

    • Serum total thyroxine (TT4), free thyroxine (FT4), and free triiodothyronine (FT3) were measured in 42 epilepsy patients on anticonvulsants.

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  • Patients received phenytoin, phenobarbitone, and carbamazepine, singly or in combination.
  • Thyroid hormone levels were compared to a control group.

    • Main Results:

    • A significant reduction in TT4, FT4, and FT3 was observed in the anticonvulsant-treated group compared to controls.
    • Phenytoin demonstrated a significant depressant effect on TT4, FT4, FT3, and reverse T3 (rT3).
    • Significant interactions were noted between drug combinations for specific thyroid hormone levels.

    Conclusions:

    • Anticonvulsant use in epilepsy is associated with reduced serum total and free thyroid hormone levels.
    • Increased clearance of thyroid hormones is suggested as a mechanism.
    • Phenytoin appears to have the most pronounced effect on thyroid hormone levels among the studied anticonvulsants.