Asif Javed1, Brian Cohen1, Kamil Detyniecki2, Lawrence J Hirsch2, Alexander Legge1, Baibing Chen2, Carl Bazil1, Kenneth Kato1, Richard Buchsbaum3, Hyunmi Choi4. 1. Comprehensive Epilepsy Center, Department of Neurology, College of Physicians and Surgeons, Columbia University, Box NI-135, 710 West 168th Street, New York, NY 10032, USA. 2. Comprehensive Epilepsy Center, Department of Neurology, Yale University, PO Box 208018, New Haven, CT 06520-8018, USA. 3. Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032, USA. 4. Comprehensive Epilepsy Center, Department of Neurology, College of Physicians and Surgeons, Columbia University, Box NI-135, 710 West 168th Street, New York, NY 10032, USA. Electronic address: hc323@columbia.edu.
Abstract
PURPOSE: Impact of adverse effects of antiepileptic medications (AEDs) such as cognitive side effects (CSEs) on quality of life can be significant. Here we provide an extended follow-up to our earlier study to investigate the predictors of cognitive side effects (CSEs) and relative frequency of CSEs among all commonly used AEDs. METHODS: In this retrospective study, medical records of 2860 adult outpatients with epilepsy seen at our center over a 12-year period who had taken one or more AEDs were examined. RESULTS: Of 2860 patients, 15% had intolerable CSEs attributed to at least one AED. On multiple logistic regression analysis, independent predictors of intolerable CSEs were lack of intellectual disability and polytherapy. In polytherapy, we found that intolerable CSEs were most commonly seen with topiramate (22.8% of 281 patients), significantly more than with almost all other AEDs. This was true in monotherapy as well, with significantly more intolerable CSEs occurring with topiramate (18.5% of 54 patients) than with gabapentin, carbamazepine, lamotrigine, and levetiracetam. AEDs with consistently low rates of ICSEs included gabapentin, pregabalin, lamotrigine, levetiracetam and carbamazepine. CONCLUSION: These data can help facilitate selection of AEDs.
PURPOSE: Impact of adverse effects of antiepileptic medications (AEDs) such as cognitive side effects (CSEs) on quality of life can be significant. Here we provide an extended follow-up to our earlier study to investigate the predictors of cognitive side effects (CSEs) and relative frequency of CSEs among all commonly used AEDs. METHODS: In this retrospective study, medical records of 2860 adult outpatients with epilepsy seen at our center over a 12-year period who had taken one or more AEDs were examined. RESULTS: Of 2860 patients, 15% had intolerable CSEs attributed to at least one AED. On multiple logistic regression analysis, independent predictors of intolerable CSEs were lack of intellectual disability and polytherapy. In polytherapy, we found that intolerable CSEs were most commonly seen with topiramate (22.8% of 281 patients), significantly more than with almost all other AEDs. This was true in monotherapy as well, with significantly more intolerable CSEs occurring with topiramate (18.5% of 54 patients) than with gabapentin, carbamazepine, lamotrigine, and levetiracetam. AEDs with consistently low rates of ICSEs included gabapentin, pregabalin, lamotrigine, levetiracetam and carbamazepine. CONCLUSION: These data can help facilitate selection of AEDs.
Authors: Robert J Quon; Morgan T Mazanec; Samantha S Schmidt; Angeline S Andrew; Robert M Roth; Todd A MacKenzie; Martha Sajatovic; Tanya Spruill; Barbara C Jobst Journal: Epilepsy Behav Date: 2020-01-29 Impact factor: 2.937
Authors: Zhenhong Hu; Christopher M Barkley; Susan E Marino; Chao Wang; Abhijit Rajan; Ke Bo; Immanuel Babu Henry Samuel; Mingzhou Ding Journal: J Cogn Neurosci Date: 2019-08-16 Impact factor: 3.225
Authors: Samuel P Callisto; Sílvia M Illamola; Angela K Birnbaum; Christopher M Barkley; Sai Praneeth R Bathena; Ilo E Leppik; Susan E Marino Journal: J Clin Pharmacol Date: 2020-04-16 Impact factor: 3.126
Authors: Immanuel Babu Henry Samuel; Christopher Barkley; Susan E Marino; Chao Wang; Sahng-Min Han; Angela K Birnbaum; Jean E Cibula; Mingzhou Ding Journal: J Clin Exp Neuropsychol Date: 2018-05-02 Impact factor: 2.475
Authors: Christopher M Barkley; Zhenhong Hu; Ann M Fieberg; Lynn E Eberly; Angela K Birnbaum; Ilo E Leppik; Susan E Marino Journal: J Clin Psychopharmacol Date: 2018-10 Impact factor: 3.153