Abstracts

The main cognitive side-effects of antiepileptic drugs (AEDs) involve attention/vigilance, psychomotor speed and memory. Traditional neuropsychological testing has been the major method of measuring cognitive function related to the use of AEDs. Uncertainty exists regarding the degree of cognitive effects primarily because many studies do not adhere to basic standards of methodology and design. The aim of this study was to assess the effect of withdrawal of AEDs in patients on monotherapy and to evaluate the usefulness of a computerized assessment package that provide measures of reported side effects like attention, choice reaction time, psychomotor speed and memory., 150 subjects who had been seizure free [gt] 2 years on drug monotherapy went through a randomised, double blind, placebo controlled study. The patients were included for 12 months or until seizure relapse. Cognitive function was assessed with the California Computerized Assessment Package at baseline and seven months after withdrawal., The major finding in this study is that withdrawal of major AEDs significantly improved performance on tests that require complex cognitive processing under time pressure. Most of the subjects were medicated with carbamazepine and valproate. The outcome of withdrawal of carbamazepine was similar to the outcome for the total study population while discontinuation of valproate only revealed a non-significant tendency in the same direction., The results suggest that seizure-free epilepsy patients on monotherapy can obtain improvement in cognitive function if they withdraw anti-epileptic treatment and that computerized cognitive testing is useful in detecting cognitive side effects related to complex cognitive processing under time pressure., (Supported by a grant from Helse [Oslash]st, Norway.)