COGNITIVE FUNCTION IN ADULT EPILEPTIC PATIENTS ON LONG-TERM SODIUM VALPROATE

A battery of psychometric tests was administered to 102 adult patients with epilepsy. Forty-eight were receiving long-term treatment with so dium valproate (VPA) as monotherapy, and 28 took a combination of VPA with either carbamazepine or phenytoin. An additional 26 patients were untreated, and the tests were also administered to 24 nonepileptic co ntrols. The polypharmacy group performed significantly less well than the other groups in 6 of the 11 tests. Overall, there were no differen ces in performance between the VPA monotherapy patients and both the d rug-free groups. However, patients with higher total and free VPA conc entrations reported more sedation and scored less well on the threshol d detection task. Patients were divided into those "tolerant" and "int olerant' to the drug in terms of these two tests. The "intolerant" gro up had a significantly earlier age of onset of epilepsy and a lower no nverbal IQ. Monotherapy with VPA is unlikely to impair cognitive funct ion and may be a suitable choice if cognitive function is an important consideration.