title: Rates and predictors of patient-reported cognitive side effects of antiepileptic drugs: An extended follow-up.
abstract: OBJECTIVE
  Impact of adverse effects of antiepileptic medications (AEDs) such as cognitive side effects (CSEs) on quality of life can be significant. Here we provide an extended follow-up to our earlier study to investigate the predictors of cognitive side effects (CSEs) and relative frequency of CSEs among all commonly used AEDs.
  
  
  METHODS
  In this retrospective study, medical records of 2860 adult outpatients with epilepsy seen at our center over a 12-year period who had taken one or more AEDs were examined.
  
  
  RESULTS
  Of 2860 patients, 15% had intolerable CSEs attributed to at least one AED. On multiple logistic regression analysis, independent predictors of intolerable CSEs were lack of intellectual disability and polytherapy. In polytherapy, we found that intolerable CSEs were most commonly seen with topiramate (22.8% of 281 patients), significantly more than with almost all other AEDs. This was true in monotherapy as well, with significantly more intolerable CSEs occurring with topiramate (18.5% of 54 patients) than with gabapentin, carbamazepine, lamotrigine, and levetiracetam. AEDs with consistently low rates of ICSEs included gabapentin, pregabalin, lamotrigine, levetiracetam and carbamazepine.
  
  
  CONCLUSIONS
  These data can help facilitate selection of AEDs.
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, College of Physicians and Surgeons, Columbia University, Box NI-135, 710 West 168th Street, New York, NY 10032, USA.
authors.forename: Asif
authors.initials: A
authors.lastname: Javed
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, College of Physicians and Surgeons, Columbia University, Box NI-135, 710 West 168th Street, New York, NY 10032, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Cohen
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, Yale University, PO Box 208018, New Haven, CT 06520-8018, USA.
authors.forename: Kamil
authors.initials: K
authors.lastname: Detyniecki
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, Yale University, PO Box 208018, New Haven, CT 06520-8018, USA.
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Hirsch
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, College of Physicians and Surgeons, Columbia University, Box NI-135, 710 West 168th Street, New York, NY 10032, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Legge
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, Yale University, PO Box 208018, New Haven, CT 06520-8018, USA.
authors.forename: Baibing
authors.initials: B
authors.lastname: Chen
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, College of Physicians and Surgeons, Columbia University, Box NI-135, 710 West 168th Street, New York, NY 10032, USA.
authors.forename: Carl
authors.initials: C
authors.lastname: Bazil
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, College of Physicians and Surgeons, Columbia University, Box NI-135, 710 West 168th Street, New York, NY 10032, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Kato
authors.affiliation: Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Buchsbaum
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, College of Physicians and Surgeons, Columbia University, Box NI-135, 710 West 168th Street, New York, NY 10032, USA. Electronic address: hc323@columbia.edu.
authors.forename: Hyunmi
authors.initials: H
authors.lastname: Choi
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D003071:Cognition / Q000187:drug effects*; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008607:Intellectual Disability / Q000150:complications; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis
chemical_list: D000927:Anticonvulsants
keywords: Antiepileptic drug; Cognition; Side effect; Tolerability