Epileptik hastalarda kullanılan antiepileptik ilaçların tiroid hormon düzeylerine etkisi

Abstract

ÖZET Çalışmamızı ; Dicle Üniversitesi Tıp Fakültesi Nöroloji Anabilim Dalı'na Ağustos 97-Kasım 97 tarihleri arasında başvuran, epilepsi tanısıyla izlenen ve en az 1 yıldır antiepileptik ilaç kullanan 40 hasta oluşturdu. 40 kişilik hasta grubunun 20'si kadın (%50), 20'si erkekti (%50). Hastalar kullandıktan ilaçlara göre 3 gruba ayrıldı. Vaiproat alan 14 hastanın yaşları 15-44 (ortalama 27,7) yaş arasında olup, ilaç kullanım sûreleri 1-4 (ort: 2,67) yıl idi. Difenilhidantoin aian 11 hastanın yaşları 18-41, (ortalama : 28,7) yıi idi. Karbamazepin alan 15 hastanın yaşları 16-43 (ortalama 28,5) yaş arasında olup, ilaç kullanım süreleri 1-3 (ortalama 2,6) yıl idi. Bu çalışma epileptik hastalarda kullanılan antiepileptik ilaçların, tiroid hormon düzeylerine etkisini araştırmak amacıyla yapıldı. T4, FT4, T3, FT3, TSH düzeyleri araştırıldı ve aşağıdaki sonuçlar elde edildi. Vaiproat alan hasta grubunda; T4 düzeyinde anlamlı azalma bulundu. FT4,T3,FT3,TSH düzeylerinde değişiklik saptanmadı. Difenilhidantoin alan hasla grubunda; T4, FT4 düzeylerinde anlamlı azalma bulundu. T3,FTs, TSH düzeylerinde değişildik saptanmadı. Karbamazepin alan hasta grubunda; T3, FT3, TSH düzeylerinde değişildik saptanmadı. T4, FT4 düzeylerinde anlamlı azalma bulundu. Î4 düzeyindeki en fazla düşüşün sırasıyla karbamazepin, vaiproat, difenilhidantoinde olduğu saptandı. FT4 düzeyindeki en fazla düşüşün difenilhidantoin alan grupta, en az etkilenmenin ise vaiproat tedavisi alan grupla olduğu sapkındı. 40SUMMARY Forty epileptic patients followed at Neurology Department of Diyarbakır Dicle University Medical School between August 1997 and November 1997 and taking antiepileptic drugs for at least a year were included in the study. Twenty of patients (50%) were male and 20 (50%) were female. Patients were divided into 3 groups according to drugs they were treated with. Ages of 14 patients using valproate were between 15 and 44 years (mean 27.7) and they were taking the medication for 1 to 4 years (mean 2.67 years). Ages of 11 patients taking phenytoln were between 18 and 41 years (mean 28.7). Fifteen patients taking carbamazepine were between 16 and 43 years of age (mean 28.5) and duration of their therapy were 1 to 3 years (mean 2.6). The aim of this study was to search the effects of antiepileptic drugs on thyroid hormone levels in epileptic patients. Levels of T4, FT4,T3,FT3 and TSH were analyzed and following results were obtained. In group of patients taking valproat, T4 levels decreased significantly. No change has been detected at FT4, T3,FT3 and TSH levels. T* and FT- (events decreased significantly at the pttfente using phenytoln. No change has been observed at T3, FÎ3 and TSH levels. There were no significant change at T3, FTa and TSH levels in the group of patients taking carbamazepine, however T4 and FT4 levels decreased significantly. The degrees of decrease at T4 levels were greater at carbamazepine, valproat and phenytoin, respectively. The most prominent decrease of FT4 levels were at the group taking phenytoin while the group treated with valproate were effected the least. 41

SUMMARY Forty epileptic patients followed at Neurology Department of Diyarbakır Dicle University Medical School between August 1997 and November 1997 and taking antiepileptic drugs for at least a year were included in the study. Twenty of patients (50%) were male and 20 (50%) were female. Patients were divided into 3 groups according to drugs they were treated with. Ages of 14 patients using valproate were between 15 and 44 years (mean 27.7) and they were taking the medication for 1 to 4 years (mean 2.67 years). Ages of 11 patients taking phenytoln were between 18 and 41 years (mean 28.7). Fifteen patients taking carbamazepine were between 16 and 43 years of age (mean 28.5) and duration of their therapy were 1 to 3 years (mean 2.6). The aim of this study was to search the effects of antiepileptic drugs on thyroid hormone levels in epileptic patients. Levels of T4, FT4,T3,FT3 and TSH were analyzed and following results were obtained. In group of patients taking valproat, T4 levels decreased significantly. No change has been detected at FT4, T3,FT3 and TSH levels. T* and FT- (events decreased significantly at the pttfente using phenytoln. No change has been observed at T3, FÎ3 and TSH levels. There were no significant change at T3, FTa and TSH levels in the group of patients taking carbamazepine, however T4 and FT4 levels decreased significantly. The degrees of decrease at T4 levels were greater at carbamazepine, valproat and phenytoin, respectively. The most prominent decrease of FT4 levels were at the group taking phenytoin while the group treated with valproate were effected the least. 41