Investigation of the Effect of Antiseizure Medications on Cognition in Patients With Epilepsy

Abstract

Background. The effect of antiseizure medications (ASMs) on cognition varies depending on the type of ASM. We aimed to investigate the effects of ASMs on patients with epilepsy based on the conflicting findings in the literature. Methods. Patients diagnosed with epilepsy who were taking ASMs were included. All patients underwent a neuropsychiatric assessment, Beck Depression and Anxiety Inventories, Positive and Negative Syndrome Scale, and general psychopathological tests. The patients were divided into polytherapy and monotherapy groups. Subgroups were categorized according to the type of ASMs, dosage, and duration of monotherapy. Results. Ninety-seven patients were included in this study. The polytherapy group showed a significant decrease in attention, total learning, and interpretation of proverbs compared to the monotherapy group. In the monotherapy group, carbamazepine use had a moderate positive correlation with working memory ( r = .669; P = .034), and a strong negative correlation with maintaining attention ( r = −.740; P = .014). The duration of levetiracetam monotherapy was negatively correlated with verbal memory (immediate recall r = −.436, P = .038; free recall r = .426, P = .043) and negatively weakly correlated with naming performance ( r = −.488, P = .025). Conclusion. The study showed polytherapy may affect verbal and working memory. Carbamazepine may affect working memory and the maintenance of attention in a dose-dependent manner. Levetiracetam may cause impairments in verbal memory and naming, depending on the duration of usage.