Isojärvi J I, Airaksinen K E, Mustonen J N, Pakarinen A J, Rautio A, Pelkonen O, Myllylä V V
Department of Neurology, University of Oulu, Finland.
Epilepsia. 1995 Aug;36(8):810-6. doi: 10.1111/j.1528-1157.1995.tb01619.x.
We determined changes in serum concentrations of thyroid hormones during carbamazepine (CBZ) therapy during a 5-year prospective follow-up study of 20 patients with newly diagnosed epilepsy. In addition, we evaluated the effects of replacing CBZ with oxcarbazepine (OCBZ) in 12 male patients with epilepsy in a 6-month prospective follow-up study. Circulating thyroxine and free thyroxine levels decreased after 2-month CBZ treatment and remained at a low level during the 5-year follow-up. There were no associated changes in serum thyrotropin (TSH) concentrations. When CBZ was replaced by OCBZ, the function of the liver's P450 enzyme system normalized, as shown by an increase in antipyrineT1/2, and a decrease in antipyrineCL. Serum total and free thyroxine levels increased, and thereafter serum TSH levels decreased. Indexes of diastolic heart function improved concomitantly, which may reflect subclinical hypothyroidism at the cellular level during CBZ treatment. We conclude that normal thyroid function can be restored in patients with epilepsy by replacing CBZ with OCBZ.
在一项对20例新诊断癫痫患者的5年前瞻性随访研究中，我们测定了卡马西平（CBZ）治疗期间甲状腺激素的血清浓度变化。此外，在一项对12例男性癫痫患者的6个月前瞻性随访研究中，我们评估了用奥卡西平（OCBZ）替代CBZ的效果。CBZ治疗2个月后，循环甲状腺素和游离甲状腺素水平下降，并在5年随访期间维持在低水平。血清促甲状腺激素（TSH）浓度无相关变化。当CBZ被OCBZ替代时，肝脏P450酶系统功能恢复正常，表现为安替比林T1/2增加和安替比林清除率（CL）降低。血清总甲状腺素和游离甲状腺素水平升高，随后血清TSH水平降低。舒张期心脏功能指标随之改善，这可能反映了CBZ治疗期间细胞水平的亚临床甲状腺功能减退。我们得出结论，用OCBZ替代CBZ可使癫痫患者恢复正常甲状腺功能。
