Behavioral and Cognitive Effects of Antiepileptic Drugs

Abstract

Antiepileptic drugs (AEDs) are the major therapeutic modality for seizures and are frequently used for other indications (e.g., pain and psychiatric disorders). Thus, the behavioral and cognitive effects of AEDs including differential effects are important. The risks of AED cognitive effects are increased with certain AEDs, polypharmacy, higher dosage, and higher AED blood levels. AED cognitive effects can be clinically significant since they can impair psychomotor processing speed, sustained attention, memory, dual processing, and quality of life. Special concern should be directed at patients dependent on these skills for work or school. Further, fetal exposure to some AEDs (e.g., valproate) may have long-lasting neurodevelopment consequences. Most AEDs can produce negative behavioral effects, but some can also have positive psychotropic effects (e.g., carbamazepine, lamotrigine, valproate).