NEUROPSYCHOLOGICAL EFFECTS OF ANTIEPILEPTIC DRUGS - A CURRENT PERSPECTIVE

Epilepsy has widespread direct and indirect effects on the patient's q uality of life. These patients generally have neuropsychological impai rments that lower their educational and occupational levels of achieve ment, and many have additional emotional and/or behavioral disorders. Multiple factors underlie the cognitive changes associated with epilep sy, including the effect of antiepileptic drug (AED) therapy itself. A lthough it is recognized that the beneficial results of reduced seizur e frequency may compensate at least in part for detrimental cognitive AED side effects, polypharmacy and higher AED blood levels can shift t his balance. Further, there is much debate concerning the existence an d clinical importance of differential AED cognitive side effects. Whil e all the major AEDs can produce cognitive side effects, more recent r esearch indicates that the magnitude of these effects may not be clini cally significant with monotherapy within standard therapeutic range. The impact of AED differential cognitive side effects on the patient's quality of life is only beginning to be appreciated as research focus es on this important aspect of patient management. The information gai ned from such investigations will influence not only current therapeut ic decisions, but also the development of future anticonvulsants.