1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-4-20 10.15844/pedneurbriefs-4-3-5 Seizure Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Cognitive Effects of Anticonvulsants http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 03 1990 01 08 2016 4 3 20 20 Copyright: © 1990 The Author(s) 1990 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Comparative cognitive effects of anticonvulsants

The neuropsychological effects of carbamazepine, phenobarbital, and phenytoin in 15 patients with partial complex epilepsy were investigated at the Department of Neurology, Medical College of Georgia, Augusta, GA.

 Neuropsychological Effects Triple Crossover Design Digit Symbol Performance

The neuropsychological effects of carbamazepine, phenobarbital, and phenytoin in 15 patients with partial complex epilepsy were investigated at the Department of Neurology, Medical College of Georgia, Augusta, GA. Patients were treated with each drug for three months, using a randomized double-blind, triple crossover design. Neuropsychological tests included digit span, selective reminding test, digit symbol, finger tapping, grooved pegboard, choice reaction time, P3 evoked potential, and profile of mood states. Anticonvulsant blood levels were converted to a percentage of the standard therapeutic ranges. Separate analyses of covariance using percentage blood levels and seizure frequency were performed for each of the cognitive variables. Digit symbol performance with phenobarbital was significantly worse than with the other two anticonvulsants but otherwise the neuropsychological performance was comparable during treatment with each of the drugs. [1]

COMMENT. All major anticonvulsant drugs may produce cognitive deficits. The effects are dose dependent and may occur even when anticonvulsant blood levels are well within the established therapeutic ranges. Cognitive deficits are particularly prominent with polypharmacy [2]. The present study conducted in adults has shown that any differential cognitive effects of anticonvulsants must be subtle. Neuropsychological deficits commonly associated with anticonvulsant drugs include impairments in attention and concentration, memory, information processing and motor speed. A double-blind crossover study of phenobarbital and valproic acid treatment in 21 epileptic children has shown that neuropsychological functioning was significantly worse during phenobarbital treatment. [3]

 Meador KJ Loring DW Huh K Gallagher BB King DW Comparative cognitive effects of anticonvulsants Neurology 1990 Mar 40 3 Pt 1 391 394 10.1212/WNL.40.3_Part_1.391 2314578 Trimble MR Anticonvulsant drugs and cognitive function: a review of the literature Epilepsia 1987 28 Suppl 3 S37 S45 10.1111/j.1528-1157.1987.tb05776.x 3319542 Vining EP Mellitis ED Dorsen MM Cataldo MF Quaskey SA Spielberg SP Psychologic and behavioral effects of antiepileptic drugs in children: a double-blind comparison between phenobarbital and valproic acid Pediatrics 1987 Aug 80 2 165 174 3112727