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Uzun süreli karbamazepin, fenobarbital ve valproik asid kullanımının tiroid ve paratiroid fonksiyonları üzerine etkisi

The effects of long-term carbamazepine, phenobarbital and valproic acid therapy on thyroid and parathyroid functions

Journal Name:

  • Gülhane Tıp Dergisi

Publication Year:

  • 2007

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Keywords (Original Language):

Author Name
Abstract (2. Language): 
Carbamazepine, phenobarbital and valproic acid are used as antiepileptic drugs in many types of epilepsy. Although these antiepileptic drugs are well tolerated, it is known that they have some side effects on endocrine system. In this study, we investigated the effects of carbamazepin, phenobarbital and valproic acid treatment on thyroid and parathyroid functions of 120 cases (58 female and 62 male with ages ranging between 5 months to 14 years) followed-up with the diagnosis of epilepsy, and compared these effects with those of a control group. Complete blood count, serum levels of calcium, phosphorus, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, free triiodothyronine, free thyroxine, thyroid stimulating hormone, parathyroid hormone and serum drug concentrations were measured in all cases. Carbamazepin and phenobarbital except for valproic acid significantly decreased free thyroxine levels. Free triiodothyronine and thyroid stimulating hormone levels did not differ significantly between the study and control groups. Parathormone levels significantly increased in the groups of phenobarbital and carbamazepine when compared to the control group. No significant differences were observed among the groups regarding serum calcium and phosphorus levels. We conclude that thyroid and parathyroid functions of patients using carbamazepine and phenobarbital for a long time should be regularly monitored.
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Abstract (Original Language): 
Karbamazepin, fenobarbital ve valproik asid birçok epilepsi tipinde antiepileptik ilaç olarak kullanılmaktadır. Bu antiepileptik ilaçlar iyi tolere edilmelerine rağmen endokrin sistem üzerine bazı yan etkilerinin olduğu bilinmektedir. Bu çalışmada karbamazepin, fenobarbital ve valproik asidin tiroid ve paratiroid fonksiyonları üzerine olan etkilerini epilepsi tanısı ile izlenen ve antiepileptik tedavi alan yaşları 5 ay ile 14 yıl arasında değişen 58'i kız, 62'si erkek toplam 120 olguda araştırdık. Olguların tam kan, serum kalsiyum, fosfor, alkalen fosfataz, aspartat aminotransferaz, alanin aminotransferaz, serbest triiyodotironin, serbest tiroksin, tiroid stimülan hormon, parathormon ve ilaç kan seviyeleri ölçüldü. Valproik asid dışında karbamazepin ve fenobarbitalin serbest tiroksin düzeylerini önemli oranda düşürdüğü saptandı. Serbest triiyodotironin ve tiroid stimülan hormon düzeylerinde kontrol grubuna göre anlamlı bir farklılık yoktu. Fenobarbital ve karbamazepin kullanan olgularda parathormon seviyelerinde kontrol grubuna göre istatistiksel olarak anlamlı bir yükseklik saptandı. Serum kalsiyum ve fosfor parametreleri açısından önemli bir farklılık saptanmadı. Sonuç olarak uzun süreli karbamazepin ve fenobarbital kullanan hastaların tiroid ve paratiroid fonksiyonlarının düzenli takibini önermekteyiz.
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  • 4
222-225
  • Turkish

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