The Long-Term Effect of Anticonvulsant Therapy on Thyroid Profile in Children

Author(s): Aparna Abhirami Rathnam*, Ramyaa R and Kathir Subramanian

Abstract: Background: Inadequate and contradictory data exist for the effect of anticonvulsant drugs on thyroid profile in children. Objectives: To investigate the effect long term monotherapy of phenytoin, valproate, and carbamazepine on thyroid profile. Method: A total of 66 children were included in the study. Of the total, 24.2% received carbamazepine (n=16), 25.8% received phenytoin (n=17), and 50% received valproate (n=33). Only children on anticonvulsant therapy for at least one year were included in this study. TSH, T4 and T3 by Electro-chemiluminescence immune assay (ELICA) were evaluated for each child. Children on treatment with carbamazepine and phenytoin presented with decrease in T4 and only a slight change in TSH, Children on valproate presented with change in both TSH and T4. The frequency of subclinical hypothyroidism is 25% with carbamazepine, 5.9% with phenytoin and 18.2% with valproate. A total of 16.7% children presented with subclincal hypothyroidism. A ‘p’ value of less than 0.05 is taken as significant. Conclusion: The p value for TSH is 0.001 (p<0.05) which shows that subclinical hypothyroidism is prevalent in all three drug therapies. Therefore, thyroid profile should be done before prescribing anticonvulsant therapy and should be checked periodically.

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