The influence of antiepileptic drugs on cognition: a comparison of levetiracetam with topiramate.
Levetiracetam (LEV) and topiramate (TPM) are considered highly effective novel antiepileptic drugs (AEDs) in the treatment of focal epilepsies. To explore potential side effects, this study investigated their influence on cognitive functions comparatively by means of a standardized neuropsychological test battery assessing several cognitive domains. In this observational study, cognitive changes were explored in 30 consecutively recruited patients with focal epilepsy treated with LEV and in 21 patients treated with TPM, comparing functions assessed prior to gradual initiation and after reaching steady state of the individual target dosage. Before titration, patient groups did not differ significantly with respect to cognitive performance. Whereas the LEV group manifested no change in cognitive performance after AED titration, the TPM group worsened in the cognitive domains of cognitive speed and verbal fluency, as well as short-term memory. These findings suggest that TPM, unlike LEV, may impair frontal lobe functions. The lack of cognitive side effects related to LEV treatment may be relevant for treatment decisions.
Gomer
Bettina
B
Epilepsy Centre, Neurocentre, University Hospital Freiburg, Breisacher Strasse 64, D-79106 Freiburg, Germany.
Wagner
Kathrin
K
Frings
Lars
L
Saar
Josef
J
Carius
Astrid
A
Härle
Markus
M
Steinhoff
Bernhard J
BJ
Schulze-Bonhage
Andreas
A
D000328:Adult; D000927:Anticonvulsants / Q000494:pharmacology*; D016022:Case-Control Studies; D003071:Cognition / Q000187:drug effects*; D004569:Electroencephalography / Q000379:methods; D004827:Epilepsy / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000494:pharmacology; D006801:Humans; D007360:Intelligence / Q000187:drug effects; D000077287:Levetiracetam; D008297:Male; D008570:Memory, Short-Term / Q000187:drug effects; D008875:Middle Aged; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D010889:Piracetam / Q000031:analogs & derivatives* / Q000494:pharmacology; D000077236:Topiramate; D014796:Visual Perception / Q000187:drug effects
D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose; D000077287:Levetiracetam; D010889:Piracetam