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NEUROLOGY 1990;40:391
© 1990 American Academy of Neurology

Comparative cognitive effects of anticonvulsants

K. J. Meador, MD, D. W. Loring, PhD, K. Huh, MD, B. B. Gallagher, MD, PhD and D. W. King, MD

Department of Neurology, Medical College of Georgia, Augusta, GA.

We investigated the neuropsychological effects of carbamazepine, phenobarbital, and phenytoin in 15 partial complex epilepsy patients treated with each drug for 3 months, using a randomized double-blind, triple crossover design. Neuropsychological evaluation at the end of each treatment period included Digit Span, Selective Reminding Test, Digit Symbol, Finger Tapping, Grooved Pegboard, Choice Reaction Time, P3 evoked potential, and Profile of Mood States. Employing anticonvulsant blood levels and seizure frequencies as covariates, the only significant difference was for Digit Symbol. Performance with phenobarbital was significantly worse than with the other 2 anticonvulsants despite phenobarbital's having had the lowest overall blood levels. Our data show that patients receiving carbamazepine, phenobarbital, and phenytoin have comparable neuropsychological performance on most measures. The results suggest that the differential cognitive effects of anticonvulsants may be subtle.

Address correspondence and reprint requests to Dr. Kimford J. Meador, Section of Behavioral Neurology, Department of Neurology, Medical College of Georgia, Augusta, GA 30912–3200.

Supported by Ciba-Geigy Corporation. Dr. Meador is the recipient of CIA grant # 1 KO8 AG00314 from the NIH/NIA.

Presented in part at the 41st annual meeting of the American Academy of Neurology, Chicago, IL, April 1989.

Received June 29,1989. Accepted for publication in final form August 23,1989.




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R. Kalviainen, M. Aikia, A. M. Saukkonen, E. Mervaala, and P. J. Riekkinen Sr
Vigabatrin vs Carbamazepine Monotherapy in Patients With Newly Diagnosed Epilepsy: A Randomized, Controlled Study
Arch Neurol, October 1, 1995; 52(10): 989 - 996.
[Abstract] [PDF]


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