Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-28T21:41:29.587Z Has data issue: false hasContentIssue false
  • English
  • Français

Influence of major antiepileptic drugs on neuropsychological function: Results from a randomized, double-blind, placebo-controlled withdrawal study of seizure-free epilepsy patients on monotherapy

Published online by Cambridge University Press:  20 March 2007

ERIK HESSEN ,
MORTEN I. LOSSIUS ,
IVAR REINVANG  and
LEIF GJERSTAD
ERIK HESSEN
Affiliation:
Helse Øst Health Services Research Centre, and Department of Neurology, Akershus University Hospital, Oslo, Norway
MORTEN I. LOSSIUS
Affiliation:
Helse Øst Health Services Research Centre, and Department of Neurology, Akershus University Hospital, Oslo, Norway National Center for Epilepsy, Rikshospitalet, University of Oslo, Oslo, Norway
IVAR REINVANG
Affiliation:
Department of Psychology, University of Oslo, Oslo, Norway
LEIF GJERSTAD
Affiliation:
Department of Neurology, Rikshospitalet and Faculty of Medicine, University of Oslo, Oslo, Norway
Get access Rights & Permissions [Opens in a new window]

Abstract

The aim of this study was to assess cognitive effects of anticonvulsants in a way that would yield results that are most directly applicable to epilepsy populations. This was done with a placebo-controlled, prospective, randomized, double-blind, parallel group study of anticonvulsant withdrawal in a population of subjects taking a single anticonvulsant with completely controlled seizures. Outcomes of this study on cognitive measures from the California Computerized Assessment Package have recently been reported. To aid comparison with results of prior studies, we report outcomes here on several more standard measures of neuropsychological function. The major findings were that, in subjects with therapeutic drug levels at baseline, drug withdrawal was associated with significant improvement in performance on the Controlled Oral Word Association Test and the Stroop Color–Word Interference Test. Comparable results were achieved in the subgroup taking carbamazepine. (JINS, 2007, 13, 393–400.)

Keywords

Antiepileptic drugsAEDsNeuropsychological side effectsCognitive side effectsCarbamazepine
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 13 , Issue 3 , May 2007 , pp. 393 - 400
Copyright
© 2007 The International Neuropsychological Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Aldenkamp, A.P., Alpherts, W.C., Blennow, G., Elmqvist, D., Heijbel, J., Nilsson, H.L., Sandstedt, P., Tonnby, B., Wahlander, L., & Wosse, E. (1993). Withdrawal of antiepileptic medication in children: Effects on cognitive function: The Multicentre Holmfrid study. Neurology, 43, 41–51.Google Scholar
Aldenkamp, A.P., Baker, G., Mulder, O.G., Chadwick, D., Cooper, P., Doelman, J., Duncan, R., Gassmann-Mayer, C., de Haan, G.J., Hughson, C., Hulsman, J., Overweg, J., Pledger, G., Rentmeester, T.W., Riaz, H., & Wroe, S. (2000). A multicenter, randomized clinical study to evaluate the effect on cognitive function of topiramate compared with valproate as add-on therapy to carbamazepine in patients with partial-onset seizures. Epilepsia, 41, 1167–1178.Google Scholar
Baker, G.A. & Marson, A.G. (2001). Cognitive and behavioural assessments in clinical trials: What type of measure? Epilepsy Research, 45, 163–167.Google Scholar
Benton, A.L. & Hamsher, K.D. (1989). Multilingual Aphasia Examination. Iowa City, IA: AJA Associates.
Brunbech, L. & Sabers, A. (2002). Effect of antiepileptic drugs on cognitive function in individuals with epilepsy: A comparative review of newer versus older agents. Drugs, 62, 593–604.Google Scholar
Chen, Y.J., Chi Chow, J., & Lee, I. (2001). Comparison the cognitive effect of anti-epileptic drugs in seizure-free children with epilepsy before and after drug withdrawal. Epilepsy Research, 44, 65–70.Google Scholar
Cochrane, H.C., Marson, A.G., Baker, G.A., & Chadwick, D.W. (1998). Neuropsychological outcomes in randomized controlled trials of antiepileptic drugs: A systematic review of methodology and reporting standards. Epilepsia, 39, 1088–1097.Google Scholar
Craig, I. & Tallis, R. (1994). Impact of valproate and phenytoin on cognitive function in elderly patients: Results of a single blind randomised comparative study. Epilepsia, 35, 381–390.Google Scholar
Dodrill, C.B. (1992). Problems in the assessment of cognitive effects of antiepileptic drugs. Epilepsia, 33(Suppl. 6), S29–S32.Google Scholar
Gladsjo, J.A., Schuman, C.C., Evans, J.D., Peavy, G.M., Miller, S.W., & Heaton, R.K. (1999). Norms for letter and category fluency: Demographic corrections for age, education and ethnicity. Assessment, 6, 147–178.Google Scholar
Heaton, R.K., Grant, I., & Matthews, C.G. (1991). Comprehensive norms for an expanded Halsted-Reitan battery: Demographic corrections, research findings, and clinical applications. Odessa, FL: Psychological Assessment Resources.
Hessen, E., Lossius, M.I., Reinvang, I., & Gjerstad, L. (2006). Influence of major anti epileptic drugs on attention, reaction time, and speed of information processing: Results from a randomized, double-blind, placebo-controlled withdrawal study of seizure-free epilepsy patients receiving monotherapy. Epilepsia, 47, 2038–2045.Google Scholar
Kløve, H. (1963). Clinical neuropsychology. In F.M. Forster (Ed.), The medical clinics of North America. New York: Saunders.
Kwan, P. & Brodie, M.J. (2000). Early identification of refractory epilepsy. New England Journal of Medicine, 342, 314–319.Google Scholar
Lewis, R.F. & Rennick, P.M. (1979). Manual for the Repeatable Cognitive-Perceptual-Motor Battery. Grosse Pointe Park, MI: Axon Publishing Co.
Lossius, M.I., Stavem, K., & Gjerstad, L. (1999). Predictors for recurrence of epileptic seizures in a general epilepsy population. Seizure, 8, 476–479.Google Scholar
Matthews, C.G. & Kløve, H. (1964). Instruction manual for the Adult Neuropsychology Test Battery. Madison, WI: University of Wisconsin Medical School.
Meador, K.J. (1998). Cognitive and behavioral assessments in AED trials. Advances in Neurology, 76, 231–238.Google Scholar
Meador, K.J., Loring, D.W., Abney, O.L., Allen, M.E., Moore, E.E., Zamrini, E.Y., & King, D.W. (1993). Effects of carbamazepine and phenytoin on EEG and memory in healthy adults. Epilepsia, 34, 153–157.Google Scholar
Meador, K.J., Loring, D.W., Allen, M.E., Zamrini, E.Y., Moore, E.E., Abney, O.L., & King, D.W. (1991). Comparative cognitive effects of carbamazepine and phenytoin in healthy adults. Neurology, 41, 1537–1540.Google Scholar
Meador, K.J., Loring, D.W., Ray, P.G., Murro, A.M., King, D.W., Perrinne, K.R., Vazquez, B.R., & Kiolbasa, T. (2001). Differential cognitive and behavioral effects of carbamazepine and lamotrigine. Neurology, 56, 1177–1182.Google Scholar
Miller, E.N. (1990). California Computerized Assessment Battery (CalCAP) manual. Los Angeles: Norland Software.
Prevey, M.L., Delaney, R.C., Cramer, J.A., Cattanach, L., Collins, J.F., & Mattson, R.H. (1996). Effect of valproate on cognitive function. Comparison with carbamazepine. The Department of Veterans Affairs Epilepsy Cooperative Study 264 Group. Archives of Neurology, 53, 1008–1016.Google Scholar
Reitan, R.M. & Wolfson, D. (1985). The Halstead-Reitan Neuropsychological Test Battery. Tucson, AZ: Neuropsychology Press.
Rey, A. (1964). L'examen clinique en psychologie. Paris: Presses Univeritaires de France.
Salinsky, M.C., Binder, L.M., Oken, S.B., Storzbach, D., Aron, C.R., & Dodrill, C.B. (2002). Effects of gabapentin and carbamazepine on the EEG and cognition in healthy volunteers. Epilepsia, 45, 482–490.Google Scholar
Schmidt, M. (1996). Rey Auditory and Verbal Learning Test. A handbook. Los Angeles: Western Psychological Services.
Thompson, P., Huppert, F., & Trimble, M. (1981). Anticonvulsant drugs, cognitive function and memory. Acta Neurologica Scandinavica Supplementum, 80, 75–80.Google Scholar
Thompson, P.J. & Trimble, M.R. (1981). Sodium valproate and cognitive function in normal volunteers. British Journal of Clinical Pharmacology, 12, 819–824.Google Scholar
Trenerry, M.R., Crosson, B., DeBoe, J., & Leber, W.R. (1989). The Stroop Neuropsychological Screening Test. Odessa, FL: Psychological Assessment Resources.
Vermeulen, J. & Aldenkamp, A.P. (1995). Cognitive side-effects of chronic antiepileptic drug treatment: A review of 25 years of research. Epilepsy Research, 22, 65–95.Google Scholar
Wechsler, D. (1987). Wechsler Memory Scale–Revised manual. San Antonio, TX: The Psychological Corporation.