DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20161497

Impact of anti-epileptic drugs on cognition: a review

Jayant Rai, Aashal Shah, Preeti P. Yadav, Mayur Chaudhari

Abstract


Epilepsy is a chronic disorder of brain caused by various factors which may vary according to the patient age. In epilepsy threshold for seizure generation get reduced. It may affect patient’s living and increases morbidity. Anti-epileptic drugs are given as mono or poly-therapy for seizure control. These anti-epileptics produce side-effects which are dose and duration of the treatment dependent. One of the important side effects is impact on cognitive function of the patient. However, some anti-epileptic medications also cause improvement in the cognitive function. Newer anti-epileptics are providing better compliance and impact as compared to older ones.

 This review article provides details of impact of anti-epileptic drugs on cognitive functioning.


Keywords


Epilepsy, Seizure, Epileptogenesis, Partial seizures, Generalized seizures, Cognition, Anticonvulsants, Anti-epileptics

Full Text:

PDF

References


Epilepsy: WHO Media Centre, Fact Sheet; May 2015.

Anthony K, Ngugi CB, Kleinschmidt I, Josemir WS, Charles RN. Estimation of the burden of active and lifetime epilepsy: a meta analytic approach. Epilepsia. 2010;5(51):883-90.

Bromfield EB, JE Cavazos, Sirven JI. An introduction to epilepsy:clinical epilepsy. American Epilepsy Society; 2006.

Lowenstein DH, Chang BS. Seizures and Epilepsy. N Engl J Med. 2003;349(13):1257-66.

Robert S, Fisher CA, Alexis A, Alicia B, Cross JH, Christian E. Elger et al. A practical clinical definition of epilepsy. Epilepsia. 2014;55(4):475-82.

Ding DQZ, Dong Z, Weihong L, Qingsheng W, Jixin S, et al. Cognitive and mood effects of phenobarbital treatment in people with epilepsy in rural China: a prospective study. J Neurol Neurosurg Psychiatryx. 2012;83:1139-44.

Gillham RA, Wiedmann KD, Butler E, Larkin JG, Brodie MJ. Cognitive function in adult epileptic patients established on anticonvulsant mono-therapy. Epilepsy Res. 1990;7:219-25.

Kanner AM, Faught E, Tatum WO, Fix A, French JA. A past psychiatric history may be a risk factor for topiramate-related psychiatric and cognitive adverse events. Epilepsy Behav. 2003;4(5):548-52.

Wang WZ, Ma GY, Dai XY, Yang B, Wang TP. Efficacy assessment of phenobarbital in epilepsy: a large community-based intervention trial in rural China. Lancet Neurol. 2006;5(1):46-52.

Smith DB, Cramer JA, Collins JF, Novelly RA, Craft B. Results of a nationwide veterans administration cooperative study comparing the efficacy and toxicity of carbamazepine, phenobarbital, phenytoin, and primidone. Epilepsia. 1987;28(3):50-8.

Pulliainen VJM. Comparing the cognitive effects of phenytoin and carbamazepine in long-term mono-therapy: a two-year follow-up. Epilepsia. 1995;36(12):1195-202.

Aman MG, Paxton JW, Turbott SH. Effects of phenytoin on cognitive-motor performance in children as a function of drug concentration, seizure type, and time of medication. Epilepsia. 1994;35:172-80.

Wesnes KA, Dean AD, Wroe SJ. The cognitive and psychomotor effects of remacemide and carbamazepine in newly diagnosed epilepsy. Epilepsy Behaviour. 2009;14(3):522-8.

Aikia JL, Salmenpera T, Mervaala E, Kalviainen R. Long-term effects of tiagabine mono-therapy on cognition and mood in adult patients with chronic partial epilepsy. Epilepsy Behaviour. 2006;8(4):750-5.

Shehata GA, Hamed SA, Rageh TA, Elsorogy YB. Neuropsychological effects of antiepileptic drugs (carbamazepine versus valproate) in adult males with epilepsy. Neuropsychiatr Dis Treat. 2009;5:527-33.

Kang HC, Wu LC, Ku MH, Kim JS, Wook KD. The effects on cognitive function and behavioral problems of topiramate compared to carbamazepine as mono-therapy for children with benign rolandic epilepsy. Epilepsia. 2007;48(9):1716-23.

Lee SA, Heo K, Shin DJ, Song HK, Kim OJ. Cognitive and behavioral effects of lamotrigine and carbamazepine mono-therapy in patients with newly diagnosed or untreated partial epilepsy. Seizure. 2011;20(1):49-54.

Pulliainen VJM. Effects of phenytoin and carbamazepine on cognitive functions in newly diagnosed epileptic patients. Acta Neurol Scand. 1994;89(2):81-6.

Seidel WT. Cognitive and behavioral effects of carbamazepine in children: data from benign rolandic epilepsy. J Child Neuro. 1999;14(11):716-23.

Gillham RA, Wiedmann K, Butler E, Larkin JG, Brodie MJ. Concentration-effect relationships with carbamazepine and its epoxide on psychomotor and cognitive function in epileptic patients. J Neurology Neurosurgery Psych. 1988;51(7):929-33.

O'Dougherty WF, Cox S, Walson P. Carbamazepine plasma concentration relationship to cognitive impairment. Archive Neurology. 1987;44(8):863-7.

Sun WY, Wang W, Wu X. Attention changes in epilepsy patients following 3-month topiramate or valproate treatment revealed by event-related potential. Int J Psychophysiol. 2008;68(3):235-41.

McKee BJ, Butler E, Gillham RA, Brodie MJ. Variability and clinical relevance of the interaction between sodium valproate and carbamazepine in epileptic patients. Epilepsy Res. 1992;11(3):193-8.

Donati GG, Campistol J, Rapatz G, Daehler M, Sturm Y . The cognitive effects of oxcarbazepine versus carbamazepine or valproate in newly diagnosed children with partial seizures. Seizure. 2007;16(8):670-9.

Craig TR. Impact of valproate and phenytoin on cognitive function in elderly patients: results of a single-blind randomized comparative study. Epilepsia 1994;35(2):381-90.

Stores WP, Styles E, Zaiwalla Z. Psychological effects of sodium valproate and carbamazepine in epilepsy. Arch Dis Child. 1992;67(11):1330-7.

Spitz MC. Conversion to sodium valproate in non retarded adults with primary generalized tonic clonic seizures. J Epilepsy. 1991;4:33-8.

Glauser TA, Shinnar S, Hirtz DG, Dlugos D, Masur D. Ethosuximide, valproic acid, and lamotrigine in childhood absence epilepsy. N Engl J Med. 2010;362(9):790-9.

Browne TR, Dyken PR, Goode DJ, Penry JK, Porter RJ. Ethosuximide in the treatment of absence (peptit mal) seizures. Neurology. 1975;25(6):515-24.

Dodrill CB, Sommerville KW, Shu V. Cognitive and quality of life effects of differing dosages of tiagabine in epilepsy. Neurology. 1997;48(4):1025-31.

Sveinbjornsdottir SJ, Patsalos PN, Upton D, Thompson PJ, Duncan JS. Neuropsychological effects of tiagabine, a potential new antiepileptic drug. Seizure. 1994;3(1):29-35.

Dodrill CB, Shu V, Pixton GC, Lenz GT, Sommerville KW. Effects of tiagabine mono-therapy on abilities, adjustment, and mood. Epilepsia. 1998;39(1):33-42.

Monaco TR, Cicolin A, Borio R, Varetto A, Bergamasco L. Lack of association between vigabatrin and impaired cognition. J Int Med Res. 1997;25(5):296-301.

Kalviainen R, Saukkonen AM, Mervaala E, Riekkinen PJ, Vigabatrin vs carbamazepine mono-therapy in patients with newly diagnosed epilepsy. a randomized, controlled study. Arch Neurol. 1995;52(10):989-96.

Gonzalez PA, McQuistan A, Keating D, Brodie MJ, Parks S. Assessing retinal toxicity of vigabatrin and other gaga-ergic drugs in patients with epilepsy. Assoc Res Vision Ophthalmol. 2006:B521.

Mcguire AM, Trimble MR. Effects of vigabatrin on cognitive function and mood when used as add-on therapy in patients with intractable epilepsy. Epilepsia. 1992;33(1):128-34.

Munn R. Open study of clobazam in refractory epilepsy. Pediatr Neurol. 1993;9(6):465-9.

Andrade RGE, Rojas AM, Gonzalez AG, Quincoses MET, Chacon OM. A prospective, open, controlled and randomised study of clobazam versus carbamazepine in patients with frequent episodes of rolandic epilepsy. Revista de neurologia. 2009;49(11):581-6.

Park KS, Hwang YH, Lee HW, Suh CK, Kwon SH. Long-term efficacy and safety of zonisamide mono-therapy in epilepsy patients. J Clin Neurol. 2007;3(4):175-80.

White WT, Marino SE, Beniak TE, Leppik IE, Birnbaum AK. Zonisamide discontinuation due to psychiatric and cognitive adverse events: a case-control study. Neurology. 2010;75(6):513-8.

Kothare KJ, Mostofi N, Valencia I, Melvin JJ, Hobdell E. Efficacy and safety of zonisamide mono-therapy in a cohort of children with epilepsy. Pediatr Neurol. 2006;34(5):351-4.

Dodrill AJ, Hayes AG, Garofalo EA, Greeley CA, Greiner MJ. Cognitive abilities and adjustment with gabapentin: results of a multisite study. Epilepsy Res. 1999;35(2):109-21.

Valentin MN, Hadden R, Oakes A, Elwes R, Delamont R. Pregabalin as adjunctive therapy for partial epilepsy: an audit study in 96 patients from the South East of England. Seizure. 2009;18(6):450-2.

Ciesielski SS, Steinhoff BJ. Neuropsychological and psychiatric impact of add-on titration of pregabalin versus levetiracetam: a comparative short-term study. Epilepsy Behav. 2006;9(3):424-31.

French KA, Robbins JL, Knapp LE, Garofalo EA. Dose-response trial of pregabalin adjunctive therapy in patients with partial seizures. Neurology. 2003;60(10):1631-7.

Mohamed K, Rosenbloom L. Efficacy and tolerability of topiramate in childhood and adolescent epilepsy: a clinical experience. Seizure. 2000;9(2):13741.

Tatum WO, Faught E, Morris GL, Liporace J, Kanner A. Post-marketing antiepileptic drug survey postmarketing experience with topiramate and cognition. Epilepsia. 2001;42(9):1134-40.

Kockelmann E, Helmstaedter C. Significant improvement in frontal lobe associated neuropsychological functions after withdrawal of topiramate in epilepsy patients. Epilepsy Res. 2003;54(2-3):171-8.

Mula M, Thompson P, Sander JW. Topiramate and word-finding difficulties in patients with epilepsy. Neurology. 2003;60(7):1104-7.

Smith DBG, Davies G, Dewey M, Chadwick DW. Outcomes of add-on treatment with lamotrigine in partial epilepsy. Epilepsia. 1993;34(2):312-22.

Banks GK. Neuropsychological assessment in lamotrigine treated epileptic patients. Clin Exp Neurol. 1991;28:230-7.

Aldenkamp AP, Overweg J. Cognitive effects of lamotrigine as first-line add-on in patients with localization-related (partial) epilepsy. J Epilepsy. 1997;10:117-21.

Aikia MKR, Sivenius J, Halonen T, Riekkinen PJ. Cognitive effects of oxcarbazepine and phenytoin mono-therapy in newly diagnosed epilepsy: one year follow-up. Epilepsy Res. 1992;11(3):199-203.

Kim D, Joo EY, Lee HW, Shin WC, Hong SB. Cognitive and psychosocial effects of oxcarbazepine mono-therapy in newly diagnosed partial epilepsy. Clin Neuropharmacol. 2014;37(4):100-7.

Donati GG, Campistol J, Rapatz G, Daehler M, Sturm Y. Effects of oxcarbazepine on cognitive function in children and adolescents with partial seizures. Neurology. 2006;67(4):679-82.

Levisohn PM, Hunter SJ, Yang H, Jones J. Neurocognitive effects of adjunctive levetiracetam in children with partial-onset seizures: a randomized, double-blind, placebo-controlled, noninferiority trial. Epilepsia. 2009;50(11):2377-89.

Huang PM, Tsai JJ. Comparative cognitive effects of levetiracetam and topiramate in intractable epilepsy. Psychiatry Clin Neurosci. 2008;62(5):548-53.

Von SC, Leiz S, Holthausen H. Levetiracetam as add-on therapy in different subgroups of benign idiopathic focal epilepsies in childhood. Epilepsy Behav. 2010;17:193-8.