Cognitive function and anticonvulsant therapy: effect of monotherapy in epilepsy.
BACKGROUND
The effect of antiepileptic drugs (AED) on cognitive function was studied in 87 patients with epilepsy.


METHODS
Group A: (n = 52) started AED treatment (carbamazepine, oxcarbazepine, sodium-valproate, phenobarbital or phenytoin). Group B: (n = 27) had AED monotherapy withdrawn (carbamazepine or sodium-valproate). Group C: (n = 8) was switched from phenytoin to carbamazepine monotherapy. The patients were tested before and 4 months after change of the treatment.


RESULTS
In group A the test performances were in general unchanged. Patients who had their drug treatment withdrawn (group B) and the patients who were switched from phenytoin to carbamazepine (group C) improved in single tests. The predominant changes in performance seem to be due to practice effect.


CONCLUSIONS
Cognitive functions are only minimally influenced by AEDs after short-term treatment whereas there is a slight improvement after discontinuation of long-term administration of carbamazepine and valproate. A lack of practice effect might be the first indicator of a negative effect of AED on cognitive function.
Sabers
A
A
University Clinic of Neurology, Hvidovre Hospital, Denmark.
Møller
A
A
Dam
M
M
Smed
A
A
Arlien-Søborg
P
P
Buchman
J
J
Andersen
E B
EB
Boesen
F
F
Dam
A M
AM
Lyon
B B
BB
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects*; D003072:Cognition Disorders / Q000139:chemically induced* / Q000523:psychology; D004569:Electroencephalography / Q000187:drug effects; D004827:Epilepsy / Q000188:drug therapy* / Q000523:psychology; D005071:Evoked Potentials / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D016896:Treatment Outcome
D000927:Anticonvulsants