The cognitive impact of antiepileptic drugs
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TLDR
The data reviewed suggest that the effects exerted by an AED could vary depending on both patient characteristics and drug-related variables, and longitudinal studies are needed to improve the understanding of the influence of factors such as age, tolerance and the stability of cognitive effects.Abstract:
Effective treatment of epilepsy depends on medication compliance across a lifetime, and studies indicate that drug tolerability is a significant limiting factor in medication maintenance. Available antiepileptic drugs (AEDs) have the potential to exert detrimental effects on cognitive function and therefore compromise patient wellbeing. On the other hand, some agents may serve to enhance cognitive function. In this review paper, we highlight the range of effects on cognition linked to a variety of newer and older AEDs, encompassing key alterations in both specific executive abilities and broader neuropsychological functions. Importantly, the data reviewed suggest that the effects exerted by an AED could vary depending on both patient characteristics and drug-related variables. However, there are considerable difficulties in evaluating the available evidence. Many studies have failed to investigate the influence of patient and treatment variables on cognitive functioning. Other difficulties include variation across studies in relation to design, treatment group and assessment tools, poor reporting of methodology and poor specification of the cognitive abilities assessed. Focused and rigorous experimental designs including a range of cognitive measures assessing more precisely defined abilities are needed to fill the gaps in our knowledge and follow up reported patterns in the literature. Longitudinal studies are needed to improve our understanding of the influence of factors such as age, tolerance and the stability of cognitive effects. Future trials comparing the effects of commonly prescribed agents across patient subgroups will offer critical insight into the role of patient characteristics in determining the cognitive impact of particular AEDs.read more
Citations
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Carbamazepine Reduces Sharp Wave-Ripple Complexes and Exerts Synapse-Specific Inhibition of Neurotransmission in Ex Vivo Hippocampal Slices
Timothy A. Simeone,Segewkal Heruye,Joseph A. Kostansek,Mary Y. Yeh,Stephanie A. Matthews,Kaeli K. Samson,Kristina A. Simeone +6 more
TL;DR: In this article, the effects of carbamazepine on sharp wave-ripple complexes (SPW-Rs) and synaptic transmission at multiple hippocampal synapses were investigated. And the results suggest that the synapse-specific CBZ inhibition of neurotransmission may underlie the cognitive impairments observed with therapeutic doses of CBZ.
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Use of Animal Models for Epilepsy Research and Therapy Development
TL;DR: A significant unmet medical need still exists for approximately 30% of patients with epilepsy who are refractory to available pharmacotherapies, and the use of novel animal models will be essential to the discovery and development of transformative therapies.
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Psychosocial outcome in juvenile myoclonic epilepsy (Janz syndrome) and other genetic generalized epilepsies
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References
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TL;DR: Ethosuximide and valproic acid are more effective than lamotrigine in the treatment of childhood absence epilepsy and are associated with fewer adverse attentional effects.
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Jacqueline R. Farwell,Young Jack Lee,Deborah Hirtz,Stephen Sulzbacher,Jonas H. Ellenberg,Karin B. Nelson +5 more
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Psychologic and Behavioral Effects of Antiepileptic Drugs in Children: A Double-Blind Comparison Between Phenobarbital and Valproic Acid
Eileen P.G. Vining,E D Mellitis,M M Dorsen,Michael F. Cataldo,S A Quaskey,S P Spielberg,John M. Freeman +6 more
TL;DR: Additional, more sensitive, methods of monitoring patients while receiving these drugs is necessary because subtle but significant changes in intellectual function and behavior may be occurring.
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Pregabalin add-on treatment: a randomized, double-blind, placebo-controlled, dose-response study in adults with partial seizures.
Santiago Arroyo,Henning Anhut,Alan R. Kugler,Caroline M. Lee,Lloyd Knapp,E. A. Garofalo,Silke Messmer +6 more
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