The effect of Valproate, Levetiracetam, and Oxcarbazepine monotherapy on thyroid function in epileptic children

Abstract

Background: Epilepsy is a widespread neurological illness with significant medical, social, and psychological implications. Valproate, Oxcarbazepine, and Levetiracetam are the most regularly used long-term antiepileptic drugs (AEDs) in children today. Objectives: To assess the effect of Valproate, Levetiracetam, and Oxcarbazepine monotherapy on thyroid function of children with epilepsy. Patients and methods: This prospective observational study was carried out from May 2019 to December 2020 involving children of age group 1-12 years. Any child with newly diagnosed epilepsy being started on monotherapy with Levetiracetam/Valproate/Oxcarbazepine was included in the study. Their baseline thyroid profile and thyroid function at 6 th month and 12 th month of starting the antiepileptics were evaluated through Biochemical parameters -T3, T4 & TSH. These values were analyzed and compared by applying paired t-test to determine the effect of antiepileptic therapy on the thyroid function of the study subjects. Results: In the study, a total of 66 study participants were included of which 51 (77.3%) were males and 15 (22.7%) females. Among the study participants, generalized tonic-clonic seizures were seen in 36 (55%) study participants. As an antiepileptic treatment, Valproate was administered to 34 (51.5%), levetiracetam to 24 (36.4%), and oxcarbazepine to 8 (12.1%) of the study participants. Mean values of TSH, total T3, and total T4 scores at baseline were 1.7, 3.04, and 8.05 respectively; at 6 months were 3.17, 3.4, and 1.4 respectively, at 12 months were 4.9, 3.2, and 5.9. A significant increase in TSH and decrease in T4 values as compared to baseline levels was observed after antiepileptic therapy in the target group indicating a suppressive effect on thyroid function. Conclusion: This study has depicted a significant negative effect of anti-epileptic therapy on thyroid function in children.