Effects of different dosages of anticonvulsant drugs on mental performance in patients with chronic epilepsy.
Fifteen epileptic patients had their dose of anticonvulsant drugs changed twice, each time by 30-50 per cent of the initial medication. Before the dose change, the patients were given six especially adapted mental performance tests, which were designed to measure vigilance, reaction time and certain aspects of memory. Serum drug levels were also monitored. The main results include assessment of effects of drugs on mental performance and evaluation of the psychological tests used. (1) Vigilance and reaction time test were the most useful in evaluation of effects of various doses of the medication; the memory tasks showed similar, but less definite, trends; and rote calculation and block design were of no particular value in this study. (2) On the tests for vigilance and reaction time, the greatest number of patients performed best on the lowest dose of their medication, the respective percentages being 45.8 and 56. By comparison, fewest patients performed best on their highest dose, the percentages being 16.7 for vigilance and 12.5 for reaction time; while the percentages on medium dose were 37.5 and 31.2 on the respective tests. (3) Use of well-standardized, yet simplified, mental performance tests in combination with changes in the dosage of medication can help in reaching a compromise between acceptable seizure control and avoidance of excessive slowing of mental activity.
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D004828:Epilepsies, Partial / Q000188:drug therapy; D004827:Epilepsy / Q000188:drug therapy*; D006801:Humans; D007361:Intelligence Tests; D008568:Memory / Q000187:drug effects; D008875:Middle Aged; D010634:Phenobarbital / Q000627:therapeutic use; D010672:Phenytoin / Q000627:therapeutic use; D011324:Primidone / Q000627:therapeutic use; D011930:Reaction Time / Q000187:drug effects
D000927:Anticonvulsants; D011324:Primidone; D010672:Phenytoin; D010634:Phenobarbital