Posted by Paco (204.111.49.14) on October 28, 2000 at 19:21:01:
Topiramate Therapy Linked to Decline in
Cognitive Function
WESTPORT, CT (Reuters Health) Oct 26 - Results of a retrospective study
indicate that treatment with the antiepileptic agent topiramate may have a negative
effect on cognition, especially verbal processing.
Prompted by patient complaints, Dr. Pam J. Thompson and colleagues from
University College London, UK, reviewed the neuropsychological test scores of 18
patients with intractable epilepsy obtained before and after the initiation of
topiramate at a median dose 300 mg. They compared these scores with the scores
of 18 matched patients who underwent neuropsychological assessment at similar
time intervals.
In the November issue of the Journal of Neurology, Neurosurgery and
Psychiatry, the researchers report that treatment with topiramate was "associated
with impairments on tests of cognitive functioning, which were not seen in patients
who were not taking this drug." Verbal IQ, verbal fluency and verbal learning were
the areas most notably affected by topiramate treatment.
The researchers do not believe that the negative effects of topiramate on cognitive
function represent acute effects because all of the patients had been taking the drug
for at least 90 days. Furthermore, they say that "improvements seen in patients
reassessed after topiramate had been withdrawn or reduced provides further
support that the drug had been having a negative impact on cognition."
Dr. Thompson and colleagues say that while topiramate is "clearly" an effective
antiepileptic, patients and their families should be given "explicit advice on potential
adverse cognitive effects in the same way that candidates for epilepsy surgery are
counseled on possible cognitive sequelae." They also recommend
neuropsychological testing before and after topiramate treatment.
J Neurol Neurosurg Psychiatry 2000;69:636-641.