The purpose of the study by researchers from American University of Beirut Medical Center, Beirut, Lebanon, was to identify risk factors for subclinical hypothyroidism ( TSH, thyroid-stimulating hormone levels >5 mIU/mL ) in patients receiving Valproate ( Depakin, Depakote ) therapy.

During a period of 2 years, consecutive patients with epilepsy receiving Valproate and a control group of patients with diseases other than epilepsy attending a tertiary care neurology clinic were screened for subclinical hypothyroidism. The 2 groups were compared.

Thirty-six of 143 patients receiving Valproate ( 25.2%, mean age 8.5 years ) and none of the 35 control subjects had subclinical hypothyroidism ( P < 0.001 ).

Predictors of subclinical hypothyroidism were younger age ( OR: 1.15, cutoff age 3.9 years ); duration of treatment between 6 and 24 months versus <6 months ( OR: 2.98 ) and >24 months ( OR: 2.66 ); Valproate polytherapy with enzyme-inducing agents ( OR: 6.08 ), or polytherapy with non-enzyme-inducing agents ( OR: 3.34 ) compared with Valproate monotherapy.

Most ( 88.2% ) patients with duration of therapy >2 years were older than 3.9 years.

According to study, risk factors for subclinical hypothyroidism were young age, co-medication with antiepileptic drugs, and duration of therapy between 6 and 24 months.

Source: Journal of Pediatrics, 2007

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