@article{ACERJMB202441257,
    title = {Effect of Levetiracetam on Thyroid Hormone Levels in Epileptic Patients},
    journal = {ACE Research Journal of Microbiology and Biotechnology},
    volume = {4},
    number = {1},
    pages = {11-15},
    year = {2024},
    issn = {2520-3975},
    doi = {10.36478/acerjmb.2024.11.15},
    url = {https://theacepublications.com/article-detail.php?art=257-ACE-RJMB},
    author = {Ali Mohammed,Omar and},
    keywords = {Epilepsy, levetiracetam, thyroid function, TSH, T4, T3, antiepileptic drugs, endocrine effects},
    abstract = {Epilepsy, one of the most common neurological disorders, is typically
treated with the help of various antiepileptic drugs (AEDs). However,
since the first outcome of the treatment of AEDs is to reduce the
seizures, their systemic effects particularly on thyroid functions need to
be evaluated. One of the very commonly used AEDs is levetiracetam
which falls under the class of second‐generation AEDs and is popularly
known for its good pharmacokinetic profile with few systemic adverse
effects. The study on its effect on thyroid hormones is very inconclusive.
To study the effect of monotherapy with levetiracetam on serum levels
of thyroid hormones, TSH, T4 and T3 in patients with epilepsy. In this
cross‐sectional study, 32 patients with epilepsy receiving monotherapy
with levetiracetam for a minimum duration of six months were included.
The levels of thyroid hormones were studied in relation to reference
normal values. The data were analyzed using Student’s t‐test and
Pearson’s coefficient for finding out differences and relationship
between thyroid hormone levels and clinical variables. The mean TSH
level in levetiracetam‐treated patients was 1.68±0.95 μIU/mL and was
significantly lower than the normal reference, which is 2.65±1.15μIU/mL
(p=0.00049). Similarly T4 was also significantly reduced (6.31±2.18
μg/dL) with respect to normal values at 9.65±4.95 μg/dL (p=0.00089). T3
showed no significant difference between study group and normal
references., 1.33±0.60 ng/mL vs. 1.35±0.75 ng/mL (p=0.91). The ROC
curve identified optimal levetiracetam dosage cut‐point at 1277.79
mg/day for predicting TSH reduction with 100% sensitivity and 82.76%
specificity. Levetiracetam shows borderline thyroid activity with hardly
any effect on TSH and T4, wherein T3 levels are not measured. These
findings further justify its use in the management of chronic epilepsy,
especially in patients with a vulnerable thyroid status. More extensive,
inclusive trials may follow to reveal its chronic endocrinotoxicity effects.}
    }