The effective evaluation of thyroid status in patients on phenytoin, carbamazepine or sodium valproate attending an epilepsy clinic.

To assess the most efficient means of monitoring thyroid status in an epilepsy clinic, total thyroxine (T4), free thyroxine stimulating hormone (TSH) were measured in 71 adult patients treated long-term with either phenytoin (DPH), carbamazepine (CBZ) or sodium valproate (VAL). Twenty-seven patients with one or more abnormal thyroid hormone results were further investigated by a thyrotrophin releasing hormone (TRH) test and clinical assessment. T4 was found to be normal in 85% on VAL, 40% on CBZ and 39% on DPH. FT4 was normal in more patients, namely 95% on VAL, 70% on CBZ and 65% on DPH. The TRH tests indicated that FT4 was the most efficient screening test for hypothyroidism in this epileptic population. We estimate that the use of FT4 alone as a screening test would have reduced by 60% the number of TRH tests required.

[1]  I. Ramsay.  Drug and non-thyroid induced changes in thyroid function tests. , 1985, Postgraduate medical journal.

[2]  A. Tourkantonis,et al.  Effects of phenobarbital, diphenylhydantoin and carbamazepine on thyroid function in epileptic children. , 1984, Acta endocrinologica. Supplementum.

[3]  M. Surks,et al.  Multiple effects of 5,5'-diphenylhydantoin on the thyroid hormone system. , 1984, Endocrine reviews.

[4]  E. Perucca,et al.  A comparative study of the relative enzyme inducing properties of anticonvulsant drugs in epileptic patients. , 1984, British journal of clinical pharmacology.

[5]  L. Gram,et al.  Serum thyroid hormones and blood folic acid during monotherapy with carbamazepine or valproate , 1983, Acta neurologica Scandinavica.

[6]  S. Aanderud,et al.  THE INFLUENCE OF CARBAMAZEPINE ON THYROID HORMONES AND THYROXINE BINDING GLOBULIN IN HYPOTHYROID PATIENTS SUBSTITUTED WITH THYROXINE , 1981, Clinical endocrinology.

[7]  S. Johannessen,et al.  Influence of carbamazepine on serum thyroxine and triiodothyronine in patients with epilepsy , 1981, Acta neurologica Scandinavica.

[8]  S. Aanderud,et al.  Hypothyroidism induced by anti‐epileptic therapy , 1980, Acta neurologica Scandinavica.

[9]  L. Gavin,et al.  Serum thyroxine, free T4, triiodothyronine, and reverse-T3 in diphenylhydantoin-treated patients. , 1979, Metabolism: clinical and experimental.

[10]  K. Rootwelt,et al.  Effect of carbamazepine, phenytoin and phenobarbitone on serum levels of thyroid hormones and thyrotropin in humans. , 1978, Scandinavian journal of clinical and laboratory investigation.

[11]  G. Knöpfle,et al.  Effects of Anticonvulsant Drugs on Thyroid Hormones in Epileptic Children , 1978, Epilepsia.

[12]  J. Finucane.  Anticonvulsants and thyroid function. , 1978, British medical journal.

[13]  T. Helenius,et al.  THYROID FUNCTION TESTS IN PATIENTS ON LONG‐TERM TREATMENT WITH VARIOUS ANTICONVULSANT DRUGS , 1978, Clinical endocrinology.

[14]  K. Liewendahl,et al.  Thyroxine, triiodothyronine, and thyrotropin in serum during long-term diphenylhydantoin therapy. , 1976, Scandinavian journal of clinical and laboratory investigation.

[15]  K. Siersbaek-Nielsen,et al.  The effect of diphenylhydantoin on thyroid function. , 1974, The Journal of clinical endocrinology and metabolism.

[16]  P. Larsen,et al.  The effect of diphenylhydantoin on thyroxine metabolism in man. , 1970, The Journal of clinical investigation.

[17]  J. Oppenheimer,et al.  Studies on the thyroxine-diphenylhydantoin interaction: effect of 5,5'-diphenylhydantoin on the displacement of L-thyroxine from thyroxine-binding globulin (TBG). , 1962, Endocrinology.