The effect of antiepileptic drugs on thyroid hormonal function: causes and implications
Abstract
Epilepsy is a chronic disease and its treatment is lifelong in one-third of patients. Data from cross-sectional and prospective studies have reviewed the influence of antiepileptic drugs (AEDs) on thyroid hormones. Thyroid abnormalities were reported in one-third of the patients on AEDs. Subclinical hypothyroidism, reduced thyroxine, triiodothyronine, free thyroxine, free triiodothyronine and thyroid binding globulin concentrations were reported with phenobarbital, phenytoin, carbamazepine, valproate and oxcarbazepine, but not with lamotrigine, levitracetam, tiagabine and vigabatrine. All reported patients were clinically euthyroid and hormonal changes were reversible after AED withdrawal. The mechanisms for thyroid dysfunction with AEDs include enhanced metabolism and/or altered protein binding or interference of hypothalamic-pituitary-thyroid axis function. This review focuses on the evidence, mechanisms of thyroid abnormalities with AEDs and their clinical implications. The associations between subclinical hypothyroidism and metabolic risks due to AEDs are also discussed.
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Subclinical hypothyroidism may occur reversibly following administration of antiepileptic drugs, particularly carbamazepine, phenytoin, valproate, oxcarbazepine, but not lamotrigine, levetiracetam, tiagabine and vigabatrin.
“SCH may occur reversibly following administration of antiepileptic drugs (AED), particularly carbamazepine, phenytoin, valproate (77), oxcarbazepine, but not lamotrigine, levitracetam, tiagabine and vigabatrine (36).”
From L-T4 therapy in the presence of pharmacological interferents (2020) · cites this paper as [36]
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Side Effects of Anti-seizure Medication
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Pharmacological Interactions of Levothyroxine in Multiple-Treated Patients
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Self-citationImpact of Antiseizure Medication on Thyroid Function in Children With Epilepsy: A Case-Control Study
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- Authors
- Hamed, S. A.
- Affiliations
- Assiut University Hospitals (EG)
- Corresponding author
- Hamed, Sherifa Ahmed
- ORCID
- Hamed, Sherifa Ahmed
- Venue
- Expert Review of Clinical Pharmacology
- Publisher
- Informa UK Limited
- Published
- 2015-10-05
- Volume
- 8
- Issue
- 6
- Pages
- 741-750
- ISSN
- 1751-2433 (ISSN-L)
- 1751-2441
- OpenAlex
- W2096642600
- Cited by
- 56
- References
- 88
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 5 · 2023: 4 · 2022: 7 · 2021: 7 · 2020: 11 · 2019: 2 · 2018: 5 · 2017: 3 · 2016: 5 · 2015: 1
- FWCI
- 0.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Expert Review of Clinical Pharmacology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmacological Effects and Toxicity Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Keywords
- antiepileptic drugs, thyroid dysfunction, subclinical hypothyroidism, phenobarbital, phenytoin, carbamazepine, valproic acid, oxcarbazepine, thyroxine-binding globulin, hypothalamic-pituitary-thyroid axis, drug metabolism, drug withdrawal, metabolic risk
- MeSH terms
- Anticonvulsants, Epilepsy, Humans, Hypothyroidism, Protein Binding, Thyroid Hormones
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