Cognitive, affective, and behavioral side events in adults secondary to antiepileptic drug use

Antiepileptic drugs (AEDs) may contribute to and aggravate problems of cognition, mood, and behavior in some patients. The frequency and severity of the psychological disturbances are difficult to determine because many factors confound the interpretation of evidence whether it results from open case reports, controlled clinical trials, or neuropsychological testing. Concern about potential problems should not preclude trying an AED if other properties make the agent otherwise appropriate because the occurrence of adverse effects is often unpredictable in any given individual. Impairment can be minimized by gradual titration of dose and limiting total dose as clinically possible. If psychological problems arise and fine titration of the AED cannot eliminate the problem, the drug can be discontinued without permanent life threatening sequellae.