BACKGROUND: The relative effects of levetiracetam (LEV) and carbamazepine (CBZ) on cognitive and neurophysiologic measures are uncertain. METHODS: The effects of LEV and CBZ were compared in healthy adults using a randomized, double-blind, two-period crossover design. Outcome measures included 11 standard neuropsychological tests and the score from a cognitive-neurophysiologic test of attention and memory. Evaluations were conducted at screening, baseline pre-drug treatment, end of each maintenance phase (4 weeks), and end of each washout period after drug treatment. RESULTS: A total of 28 adults (17 women) with mean age of 33 years (range 18 to 51) completed the study. Mean maintenance doses (+/-SD) were CBZ = 564 mg/day (110) and LEV = 2,000 mg/day (0). CBZ was adjusted to mid-range therapeutic level. Mean serum levels (+/-SD) were CBZ = 7.5 mcg/mL (1.5) and LEV = 32.2 mcg/mL (11.2). An overall composite score including all measures revealed worse effects for CBZ compared to LEV (p <or= 0.001) in the primary analysis and for CBZ (p <or= 0.001) and LEV (p <or= 0.05) compared to non-drug in secondary analyses. Across the 34 individual variables, CBZ was worse than LEV on 44% (15/34); none favored CBZ. Compared to the non-drug average, CBZ was worse for 76% (26/34), and LEV was worse for 12% (4 of 34). Sensitivity and specificity of standard neuropsychological tests and the cognitive-neurophysiologic test were determined to direct future studies; detection was most accurate by the cognitive-neurophysiologic test. CONCLUSIONS:Levetiracetam produces fewer untoward neuropsychological and neurophysiologic effects than carbamazepine in monotherapy at the dosages and timeframes employed in this study.
RCT Entities:
BACKGROUND: The relative effects of levetiracetam (LEV) and carbamazepine (CBZ) on cognitive and neurophysiologic measures are uncertain. METHODS: The effects of LEV and CBZ were compared in healthy adults using a randomized, double-blind, two-period crossover design. Outcome measures included 11 standard neuropsychological tests and the score from a cognitive-neurophysiologic test of attention and memory. Evaluations were conducted at screening, baseline pre-drug treatment, end of each maintenance phase (4 weeks), and end of each washout period after drug treatment. RESULTS: A total of 28 adults (17 women) with mean age of 33 years (range 18 to 51) completed the study. Mean maintenance doses (+/-SD) were CBZ = 564 mg/day (110) and LEV = 2,000 mg/day (0). CBZ was adjusted to mid-range therapeutic level. Mean serum levels (+/-SD) were CBZ = 7.5 mcg/mL (1.5) and LEV = 32.2 mcg/mL (11.2). An overall composite score including all measures revealed worse effects for CBZ compared to LEV (p <or= 0.001) in the primary analysis and for CBZ (p <or= 0.001) and LEV (p <or= 0.05) compared to non-drug in secondary analyses. Across the 34 individual variables, CBZ was worse than LEV on 44% (15/34); none favored CBZ. Compared to the non-drug average, CBZ was worse for 76% (26/34), and LEV was worse for 12% (4 of 34). Sensitivity and specificity of standard neuropsychological tests and the cognitive-neurophysiologic test were determined to direct future studies; detection was most accurate by the cognitive-neurophysiologic test. CONCLUSIONS:Levetiracetam produces fewer untoward neuropsychological and neurophysiologic effects than carbamazepine in monotherapy at the dosages and timeframes employed in this study.
Authors: Marjolein de Groot; Linda Douw; Eefje M Sizoo; Ingeborg Bosma; Femke E Froklage; Jan J Heimans; Tjeerd J Postma; Martin Klein; Jaap C Reijneveld Journal: Neuro Oncol Date: 2012-12-11 Impact factor: 12.300
Authors: Alan Gevins; Michael E Smith; Linda K McEvoy; Aaron B Ilan; Cynthia S Chan; An Jiang; Lita Sam-Vargas; Gordon Abraham Journal: Clin Neurophysiol Date: 2010-07-08 Impact factor: 3.708
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Authors: Alan Gevins; Aaron B Ilan; An Jiang; Cynthia S Chan; Deborah Gelinas; Michael E Smith; Linda K McEvoy; Emilie Schwager; Mayra Padilla; Zachary Davis; Kimford J Meador; James Patterson; Ruth O'Hara Journal: Dement Geriatr Cogn Disord Date: 2010-11-27 Impact factor: 2.959
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Authors: S E Marino; K J Meador; D W Loring; M S Okun; H H Fernandez; A J Fessler; R P Kustra; J M Miller; P G Ray; A Roy; M R Schoenberg; V J Vahle; M A Werz Journal: Epilepsy Behav Date: 2009-01-06 Impact factor: 2.937