Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-24T13:55:18.565Z Has data issue: false hasContentIssue false

Chapter 15 - Antiepileptic drugs and cognitive disorders

Published online by Cambridge University Press:  07 October 2011

By
Albert P. Aldenkamp
Edited by
Michael R. Trimble  and
Bettina Schmitz
Michael R. Trimble
Affiliation:
Institute of Neurology, London
Bettina Schmitz
Affiliation:
Vivantes, Humdoldt-Klinikum, Berlin, Germany
Get access

Summary

Cognitive impairment is the most common comorbid disorder in epilepsy. Several new antiepileptic drugs (AEDs) have been introduced. Several studies have shown retention rate to be the best parameter of the long-term clinical usefulness of a particular drug. Cognitive side effects have been demonstrated to be one of the most important tolerability problems in chronic AED treatment. Randomized clinical trials with monotherapy in patients with newly diagnosed epilepsy represent the most accurate procedure for assessing the cognitive impact of AEDs. Definite evidence for drug-induced cognitive impairment has been established for phenobarbitone (memory impairment), phenytoin (mental slowing), and topiramate (mental slowing and dysphasia). Treatment with these drugs should consider these side effects, and patients should be monitored on a regular basis. Mild effects (mostly psychomotor slowing) were found for carbamazepine, oxcarbazepine, valproate, and lamotrigine (with mild cognitive activating effects). The effects for ethosuximide, tiagabine, gabapentin, levetiracetam, and zonisamide are inconclusive.

Keywords

depressionepilepsyfrontal lobe dysfunctionlabile depressive symptomslabile affective symptomsinterictal dysphoric disorderinterictal dysphoric disorder inventory
Type
Chapter
Information
The Neuropsychiatry of Epilepsy , pp. 153 - 164
Publisher: Cambridge University Press
Print publication year: 2011

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.)

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×