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From the Departments of Neurology (Drs. Meador, Loring, Nichols, Durkin, Gallagher, and King, and E.E. Moore and R.E. Oberzan) and Pharmacology/Toxicology (Dr. Meador), and the Office of Biostatistics (Dr. Thompson), Medical College of Georgia, Augusta, GA.
Supported by Parke-Davis Pharmaceuticals.
Presented in part at the 46th annual meeting of the American Academy of Neurology, Washington, DC, May 1994.
Received August 10, 1994. Accepted in final form December 30, 1994.
Address correspondence and reprint requests to Dr. Kimford J. Meador, Departments of Neurology and Pharmacology/Toxicology, Section of Behavioral Neurology, Medical College of Georgia, Augusta, GA 30912-3280.
NEUROLOGY 1995;45:1041-1051
The relative effects of antiepileptic drugs (AEDs) on cognition are controversial.We compared the cognitive effects of phenobarbital, phenytoin, and valproate in 59 healthy adults using a randomized, double-blind, incomplete-block, crossover design. Cognitive assessments were conducted at baseline, after 1 month on each drug (two AEDs per subject), and at two repeat baselines 11 weeks after each AED treatment. The neuropsychological battery included 12 tests, yielding 22 variables: Choice Reaction Time, P3 Event-Related Potential, Finger Tapping, Lafayette Grooved Pegboard, Selective Reminding Test, Paragraph Memory, Complex Figures, Symbol Digit Modalities Test, Stroop Test, Visual Serial Addition Test, Hopkins Symptom Checklist, and Profile of Mood States. More than one-half of the variables exhibited AED effects when compared with nondrug baselines, and all three AEDs produced some untoward effects. Differential AED effects on cognition were present for approximately one-third of the variables. Phenobarbital produced the worst performance; there was no clinically significant difference between phenytoin and valproate.
NEUROLOGY 1995;45: 1494-1499
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