Liewendahl K, Majuri H, Helenius T
Clin Endocrinol (Oxf). 1978 Mar;8(3):185-91. doi: 10.1111/j.1365-2265.1978.tb01493.x.
Thyroid function tests were studied in patients undergoing long-term treatment with various anticonvulsant drugs. Previous reports that diphenylhydantoin induces a decrease in the serum concentrations of total and free thyroxine (T4) and triiodothyronine (T3) without a change in the TSH concentration were confirmed. Diphenylhydantoin had no effect on reverse T3. Carbamazepine was also found to decrease serum T4, the free T4 index and T3 but, with the exception of T3, the decrease was smaller than that induced by diphenylhydantoin. Dipropylacetic acid did not influence the serum thyroid hormone concentrations, and neither did primidone. This demonstrates that the interaction between anticonvulsant drugs of different chemical structure and thyroid hormone metabolism is diverse. None of the drugs tested altered serum TSH or the T3 uptake test for the estimation of unsaturated thyroid hormone binding-capacity in serum. These two tests are considered diagnostically more dependable than the measurement of thyroid hormones in serum when diphenylhydantoin and carbamazepine are administered.
对接受各种抗惊厥药物长期治疗的患者进行了甲状腺功能测试。先前有报道称苯妥英会导致血清总甲状腺素（T4）、游离甲状腺素（T4）和三碘甲状腺原氨酸（T3）浓度降低，而促甲状腺激素（TSH）浓度不变，本研究证实了这一点。苯妥英对反式T3没有影响。还发现卡马西平会降低血清T4、游离T4指数和T3，但除T3外，降低幅度小于苯妥英引起的降低幅度。丙戊酸不影响血清甲状腺激素浓度，扑米酮也不影响。这表明不同化学结构的抗惊厥药物与甲状腺激素代谢之间的相互作用是多样的。所测试的药物均未改变血清TSH或用于评估血清中不饱和甲状腺激素结合能力的T3摄取试验。当使用苯妥英和卡马西平时，这两项测试在诊断上被认为比血清甲状腺激素测量更可靠。
