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-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-27T12:24:19.526Z Has data issue: false hasContentIssue false

Chapter 13 - Effects of Antiepileptic Drugs on Cognition

Published online by Cambridge University Press:  10 August 2021

By
Kimford Meador  and
Zahra Sadat-Hossieny
Edited by
Marco Mula
Marco Mula
Affiliation:
St George's Hospital Medical School, University of London
Get access

Summary

Patients with traumatic brain injury frequently develop epilepsy, cognitive dysfunction and behavioral imbalance. Understanding the interplay between antiseizure medications, mood and cognition is essential to any provider who cares for patients with TBI and seizures. Antiseizure medications can be classified into those that have low, moderate and high cognitive side effect profiles, and they can also be classified into medications that cause positive, intermediate and negative effects on mood. For example, Lamotrigine is a medication that both has low cognitive side effects and has positive effects on mood. But there is no drug without side effects, and each antiseizure medication has its own unique side effect profile. Choosing the antiseizure medication that will lead to the best outcomes for each individual patient requires evaluating the unique characteristics of each medication. Only with an understanding of the cognitive and behavioral effects of each medication is it possible to create a successful treatment regimen for each individual. This chapter will examine many antiseizure medications and their unique side effect profiles, with a focus on the cognitive and behavioral implications of each medication.

Keywords

AEDsantiepileptic medicationsantiseizure medicationsseizuremooddepressioncognition
Type
Chapter
Information
Post-traumatic Epilepsy , pp. 169 - 178
Publisher: Cambridge University Press
Print publication year: 2021

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

Meador, KJ. Cognitive effects of epilepsy and its treatments. In: Wyllie, E, Cascino, GD, Gidal, BE, Goodkin, HP, Loddenkemper, T, Sirven, JI (eds). Wyllie’s Treatment of Epilepsy: Principles & Practice, 7th Edition. Philadelphia: Lippincott Williams & Wilkins. 2020: 1058–61.Google Scholar
Dodrill, CB, Troupin, AS. Neuropsychological effects of carbamazepine and phenytoin: a reanalysis. Neurology 1991;41:141–3.CrossRefGoogle ScholarPubMed
Meador, KJ, Loring, DW, Allen, ME, et al. Comparative cognitive effects of carbamazepine and phenytoin in healthy adults. Neurology 1991;41:1537–40.Google Scholar
Hessen, E, Lossius, MI, Reinvang, I, et al. 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. J Int Neuropsychol Soc 2007;13:393–400.Google Scholar
Matagne, A, Margineanu, DG, Kenda, B, Michel, P, Klitgaard, H. Anti-convulsive and anti-epileptic properties of brivaracetam (UCB 34714),a high-affinity ligand for the synaptic vesicle protein, SV2A. Br J Pharmacol 2008;154:1662–71.CrossRefGoogle ScholarPubMed
Meador, KJ, Gevins, A, Leese, PT, et al. Neurocognitive effects of brivaracetam, levetiracetam, and lorazepam. Epilepsia 2011;52:264–72.CrossRefGoogle ScholarPubMed
Zahnert, F, Krause, K, Immisch, I, et al. Brivaracetam in the treatment of patients with epilepsy-first clinical experiences. Front Neurol 2018;9:38.Google Scholar
Meador, KJ, Seliger, J, Boyd, A, et al. Comparative neuropsychological effects of carbamazepine and eslicarbazepine acetate. Epilepsy Behav 2019;94:151–7.CrossRefGoogle ScholarPubMed
Leach, JP, Girvan, J, Paul, A, et al. Gabapentin and cognition: a double-blind, dose-ranging, placebo-controlled study in refractory epilepsy. J Neurol Neurosurg Psychiatry 1997;62:372–6.Google Scholar
Meador, KJ, Loring, DW, Ray, PG, et al. Differential cognitive effects of carbamazepine and gabapentin. Epilepsia 1999;40:1279–85.CrossRefGoogle ScholarPubMed
Salinsky, MC, Binder, LM, Oken, BS, et al. Effects of gabapentin and carbamazepine on the EEG and cognition in healthy volunteers. Epilepsia 2002;43:482–90.CrossRefGoogle ScholarPubMed
Meador, KJ, Loring, DW, Boyd, A, et al. Randomized double-blind comparison of cognitive and EEG effects of lacosamide and carbamazepine. Epilepsy Behav 2016;62:267–75.Google Scholar
Meador, KJ, Loring, DW, Ray, PG, et al. Differential cognitive and behavioral effects of carbamazepine and lamotrigine. Neurology. 2001;56:1177–82.Google Scholar
Meador, KJ, Loring, DW, Vahle, VJ, et al. Cognitive and behavioral effects of lamotrigine and topiramate in healthy volunteers. Neurology. 2005;64:2108–14.Google Scholar
Aldenkamp, AP, Arends, J, Bootsma, HP, et al. Randomized double-blind parallel-group study comparing cognitive effects of a low-dose lamotrigine with valproate and placebo in healthy volunteers. Epilepsia 2002; 43:19–26.CrossRefGoogle ScholarPubMed
Cohen, AF, Ashby, L, Crowley, D, et al. Lamotrigine (BW430C), a potential anticonvulsant. Effects on the central nervous system in comparison with phenytoin and diazepam. Br J Clin Pharmacol 1985;20:619–29.CrossRefGoogle ScholarPubMed
Hamilton, MJ, Cohen, AF, Yuen, AW, et al. Carbamazepine and lamotrigine in healthy volunteers: relevance to early tolerance and clinical trial dosage. Epilepsia 1993;34:166–73.CrossRefGoogle ScholarPubMed
Blum, D, Meador, KJ, Biton, V, et al. Cognitive effects of lamotrigine compared with topiramate in patients with epilepsy. Neurology 2006;67:400–6.Google Scholar
Vajda, FJ, Dodd, S, Horgan, D. Lamotrigine in epilepsy, pregnancy and psychiatry: a drug for all seasons? J Clin Neurosci 2013;20:13–16.CrossRefGoogle ScholarPubMed
Meador, KJ, Gevins, A, Loring, DW, et al. Neuropsychological and neurophysiological effects of carbamazepine and levetiracetam. Neurology 2007;69:2076–84.Google Scholar
Labiner, DM, Ettinger, AB, Fakhoury, TA, et al. Effects of lamotrigine compared with levetiracetam on anger, hostility, and total mood in patients with partial epilepsy. Epilepsia 2009;50:434–42.CrossRefGoogle ScholarPubMed
Marino, S, Vitaliti, G, Marino, SD, et al. Pyridoxine add-on treatment for the control of behavioral adverse effects induced by levetiracetam in children: A case–control prospective study. Ann Pharmacother, 2018:52, 645–9.Google Scholar
Donati F, , Gobbi G, , Campistol J, , et al. The cognitive effects of oxcarbazepine versus carbamazepine or valproate in newly diagnosed children with partial seizures. Seizure 2007;16:670–9.Google ScholarPubMed
Aikia, M, Kalviainen, R, Sivenius, J, et al. Cognitive effects of oxcarbazepine and phenytoin monotherapy in newly diagnosed epilepsy: one year follow-up. Epilepsy Res 1992;11:199–203.Google Scholar
Salinsky, MC, Spencer, DC, Oken, BS, et al. Effects of oxcarbazepine and phenytoin on the EEG and cognition in healthy volunteers. Epilepsy Behav 2004;5:894–902.Google Scholar
Meador, KJ, Yang, H, Piña-Garza, JE, et al. Cognitive effects of adjunctive perampanel for partial-onset seizures: A randomized trial. Epilepsia 2016;57:243–51.Google Scholar
Piña-Garza, JE, Lagae, L, Villanueva, V, et al. Long-term effects of adjunctive perampanel on cognition in adolescents with partial seizures. Epilepsy Behav 2018;83:50–8.CrossRefGoogle ScholarPubMed
Aldenkamp, AP, Alpherts, WC. The effect of the new antiepileptic drug rufinamide on cognitive functions. Epilepsia 2006;47:1153–9.CrossRefGoogle ScholarPubMed
Dodrill, CB, Arnett, JL, Sommerville, K, et al. Cognitive and quality of life effects of differing dosages of tiagabine in epilepsy. Neurology 1997;48:1025–31.Google Scholar
Sharief, M, Viteri, C, Ben-Menachem, E, et al. Double-blind, placebo-controlled study of topiramate in patients with refractory partial epilepsy. Epilepsy Res 1996;25:217–24.CrossRefGoogle ScholarPubMed
Tassinari, CA, Michelucci, R, Chauvel, P, et al. Double-blind, placebo-controlled trial of topiramate (600 mg daily) for the treatment of refractory partial epilepsy. Epilepsia 1996;37:763–86.CrossRefGoogle ScholarPubMed
Ben-Menachim, E, Henriksen O, Dam M, Schmidt D. Double-blind, placebo-controlled trial of topiramate as add-on therapy in patients with refractory partial seizures. Epilepsia 1996;37:539–43.Google Scholar
Faught, E, Wilder, BJ, Ramsay, RE, et al. Topiramate placebo- controlled dose-ranging trial in refractory partial epilepsy using 200,400, and 600-mg daily dosages. Neurology 1996;46: 1684–90.Google Scholar
Aldenkamp, AP, Baker, G, Mulder, OG, et al. 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 2000;41:1167–78.Google Scholar
Meador, KJ, Loring, DW, Hulihan, JF, et al. Differential cognitive and behavioral effects of topiramate and valproate. Neurology 2003;60:1483–8.Google Scholar
Salinsky, MC, Storzbach, D, Spencer, DC, et al. Effects of topiramate and gabapentin on cognitive abilities in healthy volunteers. Neurology 2005;64:792–8.CrossRefGoogle ScholarPubMed
Loring, DW, Williamson, DJ, Meador, KJ, et al. Topiramate dose effects on cognition: a randomized double-blind study. Neurology 2011;76: 131–7.Google Scholar
Ferrie, CD, Robinson, RO, Panayiotopoulos, CP. Psychotic and severe behavioural reactions with vigabatrin: a review. Acta Neurol Scand 1996;93:1–8.Google Scholar
Dodrill, CB, Arnett, JL, Sommerville, KW, et al. Effects of differing dosages of vigabatrin (Sabril) on cognitive abilities and quality of life in epilepsy. Epilepsia 1995;36:164–73.CrossRefGoogle ScholarPubMed
Grunewald, RA, Thompson, PJ, Corcoran, R, et al. Effects of vigabatrin on partial seizures and cognitive function. J Neurol Neurosurg Psychiatr 1994;57:1057–63.Google Scholar
Berent, S, Sackellares, JC, Giordani, B, et al. Zonisamide (CI-912) and cognition: results from preliminary study. Epilepsia. 1987;28:61–67. 2008;12:102–108.Google Scholar
Park, SP, Hwang, YH, Lee, HW, et al. Long-term cognitive and mood effects of zonisamide monotherapy in epilepsy patients. Epilepsy & Behavior 2008;12:102–8.Google Scholar
Blume, Wiebe S Girvin, W Eliasziw, J randomized, M. A, controlled trial of surgery for temporal-lobe epilepsy. N Engl J Med 2001;345:311–18Google Scholar
Dulay, M. Busch, R. Prediction of neuropsychological outcome after resection of temporal and extratemporal seizure foci. Neurosurg Focus 2012;32:E4.Google Scholar
Rolston, Chan A Rao, J, V. and Chang, E. Effect of neurostimulation on cognition and mood in refractory epilepsy. Epilepsia Open, 2018, 3:18–29.Google Scholar
Hoppe, C, Helmstaedter, C, Scherrmann, J, et al. No evidence for cognitive side effects after 6 months of vagus nerve stimulation in epilepsy patients. Epilepsy Behav 2001;2:351–6.Google Scholar
Tröster, AI, Meador, KJ, Irwin, CP, et al. Memory and mood outcomes after anterior thalamic stimulation for refractory partial epilepsy. Seizure 2017;45:133–41.Google Scholar
Loring, DW, Kapur, R, Meador, KJ, et al. Differential neuropsychological outcomes following targeted responsive neurostimulation for partial-onset epilepsy. Epilepsia 2015; 56:1836–44.CrossRefGoogle ScholarPubMed
Adams, J, Alipio-Jocson, V, Inoyama, K, et al. Methylphenidate, cognition, and epilepsy: A double-blind, placebo-controlled, single-dose study. Neurology 2017;88:470–6.Google Scholar
Adams, J, Alipio-Jocson, V, Inoyama, K, et al. Methylphenidate, cognition, and epilepsy: A 1-month open-label trial. Epilepsia 2017;58:2124–32.Google Scholar
Liu, X, Carney, PR, Bussing, R, Segal, R, Cottler, LB, Winterstein, AG. Stimulants do not increase the risk of seizure-related hospitalizations in children with epilepsy. J Child Adolesc Psychopharmacol 2018;28:111–16.Google Scholar
Wiggs, KK, Chang, Z, Quinn, PD, et al. Attention-deficit/hyperactivity disorder medication and seizures. Neurology 2018;90:e1104–10.CrossRefGoogle ScholarPubMed

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
×