Neuroscience
Werz MA, Schoenberg MR, Meador KJ, Loring DW, Ray PG, Kaul-Gupta R, & Ogrocki P. Subjective preference for lamotrigine or topiramate in healthy volunteers: Relationship to cognitive and behavioral functioning. Epilepsy and Behavior. 2005 Dec 21; [Epub ahead of print].
Department of Neurology, University Hospitals of Cleveland and Case Western Reserve University School of Medicine, Cleveland, OH, USA.
OBJECTIVE: Outcomes research emphasizes patient self-assessment and preferences in optimizing treatment. We previously showed that lamotrigine produces significantly less cognitive and behavioral impairment compared with topiramate. In the current study we extend these observations to subject self-report of preference for lamotrigine or topiramate independent of potentially confounding effects of seizures or seizure control. Additionally, drug preference was related to effects of lamotrigine and topiramate on objective neuropsychological tests as well as self-perception on behavioral instruments. METHODS: Thirty-seven healthy volunteers completed a double-blind, randomized crossover design incorporating two 12-week treatment periods of lamotrigine and topiramate each titrated to a dose of 300mg/day. Evaluation of 23 objective neuropsychological and 15 subjective behavioral measures occurred at four times: pretreatment baseline, first treatment, second treatment, and posttreatment baseline. Preference for lamotrigine or topiramate was assessed, while blinding was maintained, at the final study visit when each subject was asked which drug he or she would prefer to take. RESULTS: A large majority (70%) preferred lamotrigine, 16% stated preference for topiramate, and 14% had no preference (drugs equivalent). Consistent with preference, those preferring lamotrigine performed better on 19 of 23 objective and 13 of 15 subjective behavioral measurements while on lamotrigine. Inconsistent with preference, subjects preferring topiramate performed better on 19 of 23 objective and 9 of 15 subjective behavioral measures while on lamotrigine. Topiramate preference also did not correlate with IQ, serum concentration, body mass index, age, or gender. Topiramate preference did relate to responses on the Profile of Mood States. CONCLUSION: Lamotrigine was preferred by the majority of subjects, congruent with objective neuropsychological and subjective behavioral measures. In contrast, for those stating a preference for topiramate the results on objective neuropsychological measures were impaired while fewer complaints were noted on the Profile of Mood States. This suggests that preference for topiramate may be determined by an effect on mood.
PMID: 16377253 [PubMed - as supplied by publisher]
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Anthony H. Risser | neuroscience | neuropsychology | brain
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Neuroscience
Abstract of the Day: Patient-Reported Outcomes (PROs)
Werz MA, Schoenberg MR, Meador KJ, Loring DW, Ray PG, Kaul-Gupta R, & Ogrocki P. Subjective preference for lamotrigine or topiramate in healthy volunteers: Relationship to cognitive and behavioral functioning. Epilepsy and Behavior. 2005 Dec 21; [Epub ahead of print].
Department of Neurology, University Hospitals of Cleveland and Case Western Reserve University School of Medicine, Cleveland, OH, USA.
OBJECTIVE: Outcomes research emphasizes patient self-assessment and preferences in optimizing treatment. We previously showed that lamotrigine produces significantly less cognitive and behavioral impairment compared with topiramate. In the current study we extend these observations to subject self-report of preference for lamotrigine or topiramate independent of potentially confounding effects of seizures or seizure control. Additionally, drug preference was related to effects of lamotrigine and topiramate on objective neuropsychological tests as well as self-perception on behavioral instruments. METHODS: Thirty-seven healthy volunteers completed a double-blind, randomized crossover design incorporating two 12-week treatment periods of lamotrigine and topiramate each titrated to a dose of 300mg/day. Evaluation of 23 objective neuropsychological and 15 subjective behavioral measures occurred at four times: pretreatment baseline, first treatment, second treatment, and posttreatment baseline. Preference for lamotrigine or topiramate was assessed, while blinding was maintained, at the final study visit when each subject was asked which drug he or she would prefer to take. RESULTS: A large majority (70%) preferred lamotrigine, 16% stated preference for topiramate, and 14% had no preference (drugs equivalent). Consistent with preference, those preferring lamotrigine performed better on 19 of 23 objective and 13 of 15 subjective behavioral measurements while on lamotrigine. Inconsistent with preference, subjects preferring topiramate performed better on 19 of 23 objective and 9 of 15 subjective behavioral measures while on lamotrigine. Topiramate preference also did not correlate with IQ, serum concentration, body mass index, age, or gender. Topiramate preference did relate to responses on the Profile of Mood States. CONCLUSION: Lamotrigine was preferred by the majority of subjects, congruent with objective neuropsychological and subjective behavioral measures. In contrast, for those stating a preference for topiramate the results on objective neuropsychological measures were impaired while fewer complaints were noted on the Profile of Mood States. This suggests that preference for topiramate may be determined by an effect on mood.
PMID: 16377253 [PubMed - as supplied by publisher]
-
Anthony H. Risser | neuroscience | neuropsychology | brain
- Neuropsychology Abstract Of The Day: Fatigue
Möller MC, Nygren de Boussard C, Oldenburg C, & Bartfai A. (2014). An investigation of attention, executive, and psychomotor aspects of cognitive fatigability. Journal of Clinical and Experimental Neuropsychology. 2014 Jun 26:1-14. [Epub ahead of print]...
- Neuropsychology Abstract Of The Day: Diagnostic Value Of Subjective Complaints
Understanding the relation between subjective complaints and objective performance findings is always a crucial factor in clinical assessment. It is a source of debate by clinicians and researchers and a literature has developed examining the issues that...
- Neuropsychology Abstract Of The Day: Ms And Cognitive Rehabilitation
A randomized controlled trial of a cognitive rehabilitation intervention for persons with multiple sclerosis Clin Rehabil. 2012 Feb 2; Stuifbergen AK, Becker H, Perez F, Morison J, Kullberg V, Todd A Abstract Objective: To explore the feasibility and...
- Neuropsychology Abstract Of The Day: Epilepsy
Meador KJ, Gevins A, Loring DW, McEvoy LK, Ray PG, Smith ME, Motamedi GK, Evans BM, & Baum C. Neuropsychological and neurophysiologic effects of carbamazepine and levetiracetam. Neurology. 2007 Nov 27; 69(22): 2076-2084. Department of Neurology, University...
- Abstract Of The Day: Alzheimer Disease
Cummings JL, McRae T, & Zhang R. (2006). Effects of donepezil on neuropsychiatric symptoms in patients with dementia and severe behavioral disorders. American Journal of Geriatric Psychiatry, 14(7), 605-612. Departments of Neurology and Psychiatry and...