Abstracts

Previously, we reported that drug preference was unrelated to objective neuropsychological performance. This study examined if self-report rating scales of mood could predict participants[apos] subjective drug preference in a study of healthy volunteers taking lamotrigine (LTG) or topiramate (TPM)., This was a randomized, double-blind, double-dummy, two-period crossover study in healthy adults. A total of 37 (mean age = 38 years) completed preference data. There was no difference in age or IQ between groups ([italic]p[/italic][gt].05). Subjects were randomized to receive either LTG or TPM for 12 weeks (7 weeks of dose escalation followed by 4 weeks of maintenance therapy, and then a 1 week taper). Maintenance dose was 300 mg/day for both AEDs. Subjects then received the alternate therapy with the same dosing format. Evaluations were conducted at Screening, end of the First and Second Maintenance Phases, and the Post-treatment Phase. Side effects were recorded at each evaluation. Measures included mood assessment (QOLIE-89, SEALS, and POMS), and cognitive tests of attention, memory, language, and executive functioning. Drug preference was assessed at the end of the study. Significantly more participants (26/37, 70%) preferred LTG (LTG-P). Six (16%) preferred TPM (TPM-P) and 5 (14%) had no preference (No-P). Logistic regression was completed with baseline self-report mood and objective cognitive measures to predict subjective drug preference of LTG versus TPM., An algorithm with QOLIE Attention/Concentration and the SEALS Tiredness, and Dysphoria scales significnatly differed from zero, [Chi]²(3, N =37) = 15.05, [italic]p[/italic] [lt] .01. Participants were more likely to prefer LTG when baseline attention complaints were less, while those with more complaints of dysphoria and tiredness on the SEALS were 2.5 times more likely to prefer TPM. Using the algorithm, 87% of participants were correctly classified., Fewer attention/concentration problems and less complaints of dysphoria and tiredness was associated with a preference for LTG while the opposite was true in predicting a participants stated preference for TPM. Further studies are needed to more fully delineate factors affecting patient perceptions of medication side effects and how these variables affect attitudes of medication preference and the factors affecting compliance and quality of life., (Supported by GlaxoSmithKline.)