The effects of oxcarbazepine, levetiracetam, and lamotrigine on thyroid hormones in male adults with epilepsy_Journal of Epilepsy

Authors：

WU Dongmei ¹ , JI Fayuan ¹ ,  SUN Hongbin ²

1. People’ Hospital of Zizhong, Zizhong 641200, China;
2. Department of Neurology, Southwest Medical university, Sichuan Province People’s Hospital, Chengdu 610041, China;

Corresponding author：

SUN Hongbin, Email: shb1369@aliyun.com

Keywords：

Epilepsy; Antiepileptic drugs; Thyroid hormone

DOI：

10.7507/2096-0247.20180065

Video：

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Objectives To investigate the effects of new antiepileptic drugs [oxcarbazepine (OXC), levetiracetam (LEV), lamotrigine (LTG)] on thyroid hormones in male adults with epilepsy. Methods Thirty-eight newly diagnosed male adult patients with epilepsy were enrolled in the Epilepsy Center of Sichuan Province People's Hospital from April 2015 to November 2016. The diagnosis was in line with the classification of epilepsy defined by the International League Against Epilepsy (ILAE, 1981). Only patients with generalized or secondary generalized epilepsy were recruited into the present study. Individual treatment with OXC, LEV, or LTG was randomly assigned to the 38 patients. Thyroid hormones was measured before treatment and 6 months after taking the medicine. Followed by an analysis of the comparison between the treated patients and healthy volunteers (healthy controls) as well as the changes and differences between the patients themselves before and after treatment. Results There was no significant difference in the thyroid hormone levels between male patients with epilepsy before taking the medicine and healthy controls (P>0.05). After 6 months, total thyroxine (TT4) and free thyroxine (FT4) in OXC group was significantly lower than the baseline (P<0.05). However, the thyroid hormone levels in the LEV group and LTG group showed no statistical difference before and after treatment (P>0.05). Conclusions OXC can reduce serum total thyroxine (TT4) and free thyroxine (FT4), which might be harmful to thyroid hormone of patients.

Citation： WU Dongmei, JI Fayuan, SUN Hongbin. The effects of oxcarbazepine, levetiracetam, and lamotrigine on thyroid hormones in male adults with epilepsy. Journal of Epilepsy, 2018, 4(5): 396-399. doi: 10.7507/2096-0247.20180065 Copy

1.	Ngugi AK, Bottomley C, Kleinschmidt I, et al. Estimation of the burden of active and life-time epilepsy: a meta-analytic approach. Epilepsia, 2010, 51(5): 883-890.
2.	洪震. 癫痫流行病学研究. 中国现代神经疾病杂志, 2014, (11): 919-923.
3.	朱衡亚, 刘泉坤, 王庄, 等. 甲状腺功能亢进伴癫痫样发作相关性临床分析. 现代中西医结合杂志, 2008, (30): 4766-4767.
4.	张雄伟, 张以善, 宋晶, 等. 甲状腺功能亢进症患者治疗前后的脑功能及脑血流动力学改变. 临床神经电生理学杂志, 2006, (2): 87-89.
5.	Zhang Y X, Shen C H, Lai Q L, et al. Effects of antiepileptic drug on thyroid hormones in patients with epilepsy: A meta-analysis. Seizure, 2016, 35: 72-79.
6.	Verrotti A, Mencaroni E, Cofini M, et al. Valproic Acid Metabolism and its Consequences on Sexual Functions. Curr Drug Metab, 2016, 17(6): 573-581.
7.	Castro-Gago M, Novo-Rodriguez MI, Gomez-Lado C, et al. Evolution of subclinical hypothyroidism in children treated with antiepileptic drugs. Pediatr Neurol, 2007, 37(6): 426-430.
8.	Luef G, Kramer G, Stefan H. Oxcarbazepine treatment in male epilepsy patients improves pre-existing sexual dysfunction. Acta Neurol Scand, 2009, 119(2): 94-99.
9.	Calabro R S, Italiano D, Pollicino P, et al. Oxcarbazepine-related retrograde ejaculation. Epilepsy Behav, 2012, 25(2): 174-175.
10.	Savic I. Sex differences in human epilepsy. Exp Neurol, 2014, 259: 38-43.
11.	常琳, 王小姗. 中国癫痫流行病学调查研究进展. 国际神经病学神经外科学杂志, 2012, 39(2): 161-164.
12.	Hamed SA. The effect of epilepsy and antiepileptic drugs on sexual, reproductive and gonadal health of adults with epilepsy. Expert Rev Clin Pharmacol, 2016, 9(6): 807-819.
13.	Hamed SA. Neuroendocrine hormonal conditions in epilepsy: relationship to reproductive and sexual functions. Neurologist, 2008, 14(3): 157-169.
14.	Blume WT. Low fertility in men with epilepsy: unhappy, uninterested, unable. Epilepsy Curr, 2009, 9(3): 69-70.
15.	Verrotti A, Loiacono G, Laus M, et al. Hormonal and reproductive disturbances in epileptic male patients: emerging issues. Reprod Toxicol, 2011, 31(4): 519-527.
16.	Roste LS, Tauboll E, Haugen TB, et al. Alterations in semen parameters in men with epilepsy treated with valproate or carbamazepine monotherapy. Eur J Neurol, 2003, 10(5): 501-506.
17.	Cansu A. Antiepileptic drugs and hormones in children. Epilepsy Res, 2010, 89(1): 89-95.
18.	Isojarvi JI, Turkka J, Pakarinen AJ, et al. Thyroid function in men taking carbamazepine, oxcarbazepine, or valproate for epilepsy. Epilepsia, 2001, 42(7): 930-934.
19.	Tiihonen M, Liewendahl K, Waltimo O, et al. Thyroid status of patients receiving long-term anticonvulsant therapy assessed by peripheral parameters: a placebo-controlled thyroxine therapy trial. Epilepsia, 1995, 36(11): 1118-1125.
20.	Lossius MI, Tauboll E, Mowinckel P, et al. Reversible effects of antiepileptic drugs on thyroid hormones in men and women with epilepsy: a prospective randomized double-blind withdrawal study. Epilepsy Behav, 2009, 16(1): 64-68.
21.	Vainionpaa LK, Mikkonen K, Rattya J, et al. Thyroid function in girls with epilepsy with carbamazepine, oxcarbazepine, or valproate monotherapy and after withdrawal of medication. Epilepsia, 2004, 45(3): 197-203.
22.	Verrotti A, Basciani F, Morresi S, et al. Thyroid hormones in epileptic children receiving carbamazepine and valproic acid. Pediatr Neurol, 2001, 25(1): 43-46.
23.	Kim SH, Chung HR, Kim H, et al. Subclinical hypothyroidism during valproic acid therapy in children and adolescents with epilepsy. Neuropediatrics, 2012, 43(3): 135-139.
24.	Isojarvi JI, Pakarinen AJ, Myllyla VV. Thyroid function in epileptic patients treated with carbamazepine. Arch Neurol, 1989, 46(11): 1175-1178.
25.	Bentsen KD, Gram L, Veje A. Serum thyroid hormones and blood folic acid during monotherapy with carbamazepine or valproate. A controlled study. Acta Neurol Scand, 1983, 67(4): 235-241.
26.	喻良, 黄雨兰, 孙红斌, 等. 托吡酯与卡马西平对成年癫痫患者甲状腺激素的影响. 中风与神经疾病杂志, 2007, 24(3): 315-317.
27.	Garoufi A, Koemtzidou E, Katsarou E, et al. Lipid profile and thyroid hormone concentrations in children with epilepsy treated with oxcarbazepine monotherapy: a prospective long-term study. Eur J Neurol, 2014, 21(1): 118-123.
28.	李济世. 奥卡西平治疗癫痫对甲状腺激素水平影响的观察. 贵州医药, 2016, 40(7): 728-730.

1. Ngugi AK, Bottomley C, Kleinschmidt I, et al. Estimation of the burden of active and life-time epilepsy: a meta-analytic approach. Epilepsia, 2010, 51(5): 883-890.
2. 洪震. 癫痫流行病学研究. 中国现代神经疾病杂志, 2014, (11): 919-923.
3. 朱衡亚, 刘泉坤, 王庄, 等. 甲状腺功能亢进伴癫痫样发作相关性临床分析. 现代中西医结合杂志, 2008, (30): 4766-4767.
4. 张雄伟, 张以善, 宋晶, 等. 甲状腺功能亢进症患者治疗前后的脑功能及脑血流动力学改变. 临床神经电生理学杂志, 2006, (2): 87-89.
5. Zhang Y X, Shen C H, Lai Q L, et al. Effects of antiepileptic drug on thyroid hormones in patients with epilepsy: A meta-analysis. Seizure, 2016, 35: 72-79.
6. Verrotti A, Mencaroni E, Cofini M, et al. Valproic Acid Metabolism and its Consequences on Sexual Functions. Curr Drug Metab, 2016, 17(6): 573-581.
7. Castro-Gago M, Novo-Rodriguez MI, Gomez-Lado C, et al. Evolution of subclinical hypothyroidism in children treated with antiepileptic drugs. Pediatr Neurol, 2007, 37(6): 426-430.
8. Luef G, Kramer G, Stefan H. Oxcarbazepine treatment in male epilepsy patients improves pre-existing sexual dysfunction. Acta Neurol Scand, 2009, 119(2): 94-99.
9. Calabro R S, Italiano D, Pollicino P, et al. Oxcarbazepine-related retrograde ejaculation. Epilepsy Behav, 2012, 25(2): 174-175.
10. Savic I. Sex differences in human epilepsy. Exp Neurol, 2014, 259: 38-43.
11. 常琳, 王小姗. 中国癫痫流行病学调查研究进展. 国际神经病学神经外科学杂志, 2012, 39(2): 161-164.
12. Hamed SA. The effect of epilepsy and antiepileptic drugs on sexual, reproductive and gonadal health of adults with epilepsy. Expert Rev Clin Pharmacol, 2016, 9(6): 807-819.
13. Hamed SA. Neuroendocrine hormonal conditions in epilepsy: relationship to reproductive and sexual functions. Neurologist, 2008, 14(3): 157-169.
14. Blume WT. Low fertility in men with epilepsy: unhappy, uninterested, unable. Epilepsy Curr, 2009, 9(3): 69-70.
15. Verrotti A, Loiacono G, Laus M, et al. Hormonal and reproductive disturbances in epileptic male patients: emerging issues. Reprod Toxicol, 2011, 31(4): 519-527.
16. Roste LS, Tauboll E, Haugen TB, et al. Alterations in semen parameters in men with epilepsy treated with valproate or carbamazepine monotherapy. Eur J Neurol, 2003, 10(5): 501-506.
17. Cansu A. Antiepileptic drugs and hormones in children. Epilepsy Res, 2010, 89(1): 89-95.
18. Isojarvi JI, Turkka J, Pakarinen AJ, et al. Thyroid function in men taking carbamazepine, oxcarbazepine, or valproate for epilepsy. Epilepsia, 2001, 42(7): 930-934.
19. Tiihonen M, Liewendahl K, Waltimo O, et al. Thyroid status of patients receiving long-term anticonvulsant therapy assessed by peripheral parameters: a placebo-controlled thyroxine therapy trial. Epilepsia, 1995, 36(11): 1118-1125.
20. Lossius MI, Tauboll E, Mowinckel P, et al. Reversible effects of antiepileptic drugs on thyroid hormones in men and women with epilepsy: a prospective randomized double-blind withdrawal study. Epilepsy Behav, 2009, 16(1): 64-68.
21. Vainionpaa LK, Mikkonen K, Rattya J, et al. Thyroid function in girls with epilepsy with carbamazepine, oxcarbazepine, or valproate monotherapy and after withdrawal of medication. Epilepsia, 2004, 45(3): 197-203.
22. Verrotti A, Basciani F, Morresi S, et al. Thyroid hormones in epileptic children receiving carbamazepine and valproic acid. Pediatr Neurol, 2001, 25(1): 43-46.
23. Kim SH, Chung HR, Kim H, et al. Subclinical hypothyroidism during valproic acid therapy in children and adolescents with epilepsy. Neuropediatrics, 2012, 43(3): 135-139.
24. Isojarvi JI, Pakarinen AJ, Myllyla VV. Thyroid function in epileptic patients treated with carbamazepine. Arch Neurol, 1989, 46(11): 1175-1178.
25. Bentsen KD, Gram L, Veje A. Serum thyroid hormones and blood folic acid during monotherapy with carbamazepine or valproate. A controlled study. Acta Neurol Scand, 1983, 67(4): 235-241.
26. 喻良, 黄雨兰, 孙红斌, 等. 托吡酯与卡马西平对成年癫痫患者甲状腺激素的影响. 中风与神经疾病杂志, 2007, 24(3): 315-317.
27. Garoufi A, Koemtzidou E, Katsarou E, et al. Lipid profile and thyroid hormone concentrations in children with epilepsy treated with oxcarbazepine monotherapy: a prospective long-term study. Eur J Neurol, 2014, 21(1): 118-123.
28. 李济世. 奥卡西平治疗癫痫对甲状腺激素水平影响的观察. 贵州医药, 2016, 40(7): 728-730.

Journal of Epilepsy

The effects of oxcarbazepine, levetiracetam, and lamotrigine on thyroid hormones in male adults with epilepsy

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