COGNITIVE FUNCTION AND ANTICONVULSANT THERAPY - EFFECT OF MONOTHERAPYIN EPILEPSY

Introduction - The effect of antiepileptic drugs (AED) on cognitive fu nction was studied in 87 patients with epilepsy. Material and methods - Group A: (n = 52) started AED treatment (carbamazepine, oxcarbazepin e, sodium-valproate, phenobarbital or phenytoin). Group B: (n = 27) ha d AED monotherapy withdrawn (carbamazepine or sodium-valproate). Group C: (n = 8) was switched from phenytoin to carbamazepine monotherapy. The patients were tested before and 4 months after change of the treat ment. Results - In group A the test performances were in general uncha nged. Patients who had their drug treatment withdrawn (group B) and th e patients who were switched from phenytoin to carbamazepine (group C) improved in single tests. The predominant changes in performance seem to be due to practice effect. Conclusion - Cognitive functions are on ly minimally influenced by AEDs after short-term treatment whereas the re is a slight improvement after discontinuation of long-term administ ration of carbamazepine and valproate. A lack of practice effect might be the first indicator of a negative effect of AED on cognitive funct ion.