Effects of Antiepileptic Monotherapy with Clobazam, Phenobarbital, Carbamazepine, and Levetiracetam on Thyroid Hormone Profiles in Children Aged ۲–۱۶ Years

Background: Antiepileptic drugs (AEDs) constitute the cornerstone of epilepsy management in children. However, accumulating evidence suggests that certain AEDs may alter endocrine function, particularly the hypothalamic–pituitary–thyroid axis. Given the critical role of thyroid hormones in growth and neurodevelopment, clarifying the endocrine safety profile of these agents in pediatric populations is clinically essential.Objective: To evaluate the effects of carbamazepine, phenobarbital, clobazam, and levetiracetam on serum thyroid hormone levels (TSH, FT۴, and T۳) in children aged ۲–۱۶ years over a ۶-month treatment period.Methods: In this prospective before-and-after interventional study, ۸۰ children with epilepsy receiving monotherapy (۲۰ per drug group) were enrolled. Baseline demographic and anthropometric characteristics were comparable across groups. Serum TSH, FT۴, and T۳ levels, along with weight and height, were measured at treatment initiation and after ۶ months. Within-group changes were analyzed using paired t tests, and between-group differences were assessed using one-way analysis of variance (ANOVA). Statistical significance was defined as P < ۰.۰۵.Results: After ۶ months, significant alterations in FT۴ and T۳ levels were observed exclusively in the carbamazepine group (P < ۰.۰۵), with mean hormonal changes differing significantly from those in the other treatment groups. No significant thyroid hormone changes were detected in the phenobarbital, clobazam, or levetiracetam groups. Although weight and height increased significantly in all groups (P < ۰.۰۱), the magnitude of growth changes did not differ between treatments.Conclusion: Carbamazepine was associated with measurable alterations in thyroid hormone levels over ۶-month, whereas phenobarbital, clobazam, and levetiracetam demonstrated relative short-term endocrine stability. Ongoing thyroid function monitoring may be warranted, particularly in children receiving conventional enzyme-inducing AEDs.

کلیدواژه ها:

Antiepileptic Drugs ، Carbamazepine ، Epilepsy ، Levetiracetam ، Pediatric ، thyroid function