Cognitive effects of topiramate, gabapentin, and lamotrigine in healthy young adults

Objective: To study the acute and steady-state cognitive effects of three n ew antiepileptic drugs (AEDs): gabapentin, lamotrigine, and topiramate. Bac kground: Several newer antiepileptic medications approved recently by the F ood and Drug Administration are gaining attention as efficacious alternativ es to established AEDs. Greater tolerability with fewer side effects are re ported in some. However, the potential cognitive effects of these newer AED s have received limited attention. Methods: Healthy young adults randomized to either of the three drugs were administered tests of attention, psychom otor speed, language, memory, and mood at baseline (predrug), acute single- dose period, and after 2 and 4 weeks on the drug. Results: Compared with ba seline, the topiramate group had selective, statistically significant decli nes on measures of attention and word fluency at acute doses, whereas the o ther two AED groups had no performance changes. At the 2- and 4-week test p eriods, only the topiramate subjects continued to display neurocognitive ef fects from drug administration. Conclusions: Results demonstrate potential acute and steady-state adverse cognitive effects for topiramate, whereas mi nimal effects were displayed for either gabapentin or lamotrigine in young healthy adults.