Author:
Ali Mohammed Khaleel Al‐Balki, Omar Abduladheem Mohammed and Akram Mohammed Al‐Mahdawi
Page: 11-15
Published online: 15 Oct 2024
https://doi.org/10.36478/acerjmb.2024.11.15
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.