2006 issue 4

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Volume 15, issue 4

Review article

The effect of antiepileptic medication on cognitive functions

KRZYSZTOF SOŁTYS1
1. Kliniki Psychiatrii Rozwojowej, Zaburzeń Psychotycznych i Wieku Podeszłego Akademii Medycznej w Gdańsku
Postępy Psychiatrii i Neurologii 2006; 15 (4): 307-276
Keywords: antiepileptic drugs, cognitive functions
Abstract

Background. The literature is reviewed concerning the effect of antiepileptic drugs on cognitive functions in healthy volunteers and in patients treated for epilepsy or mental disorders.

Review. Antiepileptic drugs of "older generation " affect cognitive functioning efficacy. This adverse effect is most pronounced in case of barbiturates and benzodiazepines administration, and less marked for phenytoin. On the other hand, probably no clinically significant changes in cognitive functions ensuefrom monotherapy with standard dosage of carbamazepine and valproates. "New generation " antiepileptic drugs have a differentiated effect on cognitive functions. Research on the use ofgabapentine, oxcarbazepine, vigabatrine, and tiagabine does not indicate any negative effects of these drugs on cognitive functions. As regards lamotrigine, an improvement in cognitive tests performance was even observed. Only the administration of topomirate was followed by a deterioration in some subjects' test performance.

Conclusions. The effect of antiepileptic drugs on cognitive functions is differentiated. An evident cognitive impairment is associated with some "older generation " pharmaceuticals. As far as "new generation " drugs are concerned, adverse effects were seen in some persons receiving topomirate. It should be noted that rather few studies reported in the literature deal with these problems. Moreover, methodological difficulties may affect credibility of the research findings.

Address for correspondence:
Dr Krzysztof Sołtys, Klinika Psychiatrii Rozwojowej, Zaburzeń Psychotycznych i Wieku Podeszłego Akademii Medycznej,
ul. Srebrniki 1, 80-282 Gdańsk, e-mail: ksoltys@amg.gda.pl