Neuroscience
The cognitive impact of antiepileptic drugs
Ther Adv Neurol Disord. 2011 Nov; 4(6): 385-407
Eddy CM, Rickards HE, Cavanna AE
Abstract
Effective treatment of epilepsy depends on medication compliance across a lifetime, and studies indicate that drug tolerability is a significant limiting factor in medication maintenance. Available antiepileptic drugs (AEDs) have the potential to exert detrimental effects on cognitive function and therefore compromise patient wellbeing. On the other hand, some agents may serve to enhance cognitive function. In this review paper, we highlight the range of effects on cognition linked to a variety of newer and older AEDs, encompassing key alterations in both specific executive abilities and broader neuropsychological functions. Importantly, the data reviewed suggest that the effects exerted by an AED could vary depending on both patient characteristics and drug-related variables. However, there are considerable difficulties in evaluating the available evidence. Many studies have failed to investigate the influence of patient and treatment variables on cognitive functioning. Other difficulties include variation across studies in relation to design, treatment group and assessment tools, poor reporting of methodology and poor specification of the cognitive abilities assessed. Focused and rigorous experimental designs including a range of cognitive measures assessing more precisely defined abilities are needed to fill the gaps in our knowledge and follow up reported patterns in the literature. Longitudinal studies are needed to improve our understanding of the influence of factors such as age, tolerance and the stability of cognitive effects. Future trials comparing the effects of commonly prescribed agents across patient subgroups will offer critical insight into the role of patient characteristics in determining the cognitive impact of particular AEDs.
PMID: 22164192 [PubMed - in process]
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Neuroscience
Neuropsychology Abstract of the Day: Epilepsy
The cognitive impact of antiepileptic drugs
Ther Adv Neurol Disord. 2011 Nov; 4(6): 385-407
Eddy CM, Rickards HE, Cavanna AE
Abstract
Effective treatment of epilepsy depends on medication compliance across a lifetime, and studies indicate that drug tolerability is a significant limiting factor in medication maintenance. Available antiepileptic drugs (AEDs) have the potential to exert detrimental effects on cognitive function and therefore compromise patient wellbeing. On the other hand, some agents may serve to enhance cognitive function. In this review paper, we highlight the range of effects on cognition linked to a variety of newer and older AEDs, encompassing key alterations in both specific executive abilities and broader neuropsychological functions. Importantly, the data reviewed suggest that the effects exerted by an AED could vary depending on both patient characteristics and drug-related variables. However, there are considerable difficulties in evaluating the available evidence. Many studies have failed to investigate the influence of patient and treatment variables on cognitive functioning. Other difficulties include variation across studies in relation to design, treatment group and assessment tools, poor reporting of methodology and poor specification of the cognitive abilities assessed. Focused and rigorous experimental designs including a range of cognitive measures assessing more precisely defined abilities are needed to fill the gaps in our knowledge and follow up reported patterns in the literature. Longitudinal studies are needed to improve our understanding of the influence of factors such as age, tolerance and the stability of cognitive effects. Future trials comparing the effects of commonly prescribed agents across patient subgroups will offer critical insight into the role of patient characteristics in determining the cognitive impact of particular AEDs.
PMID: 22164192 [PubMed - in process]
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Frings L, Wagner K, Maiwald T, Carius A, Schinkel A, Lehmann C, & Schulze-Bonhage A. Early detection of behavioral side effects of antiepileptic treatment using handheld computers. Epilepsy and Behavior. 2008 Aug; 13(2) :402-406. Epilepsy Center, University...
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Hill SK, Sweeney JA, Hamer RM, Keefe RS, Perkins DO, Gu H, McEvoy JP, & Lieberman JA. Efficiency of the CATIE and BACS neuropsychological batteries in assessing cognitive effects of antipsychotic treatments in schizophrenia. Journal of the International...
- 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...