title: The cognitive effects of oxcarbazepine versus carbamazepine or valproate in newly diagnosed children with partial seizures.
abstract: OBJECTIVE
  To investigate the effect of oxcarbazepine against standard antiepileptic drug therapy (carbamazepine and valproate) on cognitive function in children and adolescents (aged 6 to <17 years) with newly diagnosed partial seizures.
  
  
  METHODS
  A multicentre, open-label, randomised, active-control, three-arm, parallel-group, 6-month study. The primary cognitive variable, the Computerized Visual Searching Task (CVST), assessed mental information processing speed and attention. Secondary variables included additional tests assessing psychomotor speed, alertness, memory and learning, and non-verbal intelligence.
  
  
  RESULTS
  Of 112 patients randomised, 99 completed the study. The dropout rate was 11.6%; 13 patients discontinued due to adverse events (n=5) or unsatisfactory therapeutic effect (n=8). Mean CVST time decreased in all groups, indicating an improvement of mental processing speed and no cognitive impairment in any treatment group. No statistically significant difference was observed between oxcarbazepine and combined carbamazepine/valproate. Analysis of secondary variables did not show statistically significant differences between oxcarbazepine, carbamazepine and valproate. Analysis of intelligence test results showed that the number of correct answers increased at end point in all groups. The percentage of patients remaining seizure free throughout treatment was comparable across all groups (oxcarbazepine 58%; carbamazepine 46%; valproate 54%; carbamazepine/valproate 50%). The most common adverse events were fatigue and headache for oxcarbazepine, fatigue and rash for carbamazepine, and headache, increased appetite and alopecia for valproate.
  
  
  CONCLUSIONS
  Oxcarbazepine treatment over 6 months does not display any differential effects on cognitive function and intelligence in children and adolescents with newly diagnosed partial seizures relative to standard antiepileptic drug therapy. No impairment in cognitive function was observed in any treatment group over a 6-month period.
authors.affiliation: Department of Neurology, Spitalzentrum Biel, Vogelsang 84, CH-2501 Biel, Switzerland. Filippo.Donati@spital-biel.ch
authors.forename: Filippo
authors.initials: F
authors.lastname: Donati
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gobbi
authors.forename: Jaume
authors.initials: J
authors.lastname: Campistol
authors.forename: Guenter
authors.initials: G
authors.lastname: Rapatz
authors.forename: Maja
authors.initials: M
authors.lastname: Daehler
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Sturm
authors.forename: Albert P
authors.initials: AP
authors.lastname: Aldenkamp
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use*; D002220:Carbamazepine / Q000031:analogs & derivatives; D002648:Child; D003071:Cognition / Q000187:drug effects*; D004341:Drug Evaluation; D004828:Epilepsies, Partial / Q000188:drug therapy* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D000078330:Oxcarbazepine; D014635:Valproic Acid
chemical_list: D000927:Anticonvulsants; D002220:Carbamazepine; D014635:Valproic Acid; D000078330:Oxcarbazepine