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Anticonvulsant drugs, behavior, and cognitive abilities

M Trimble

    Current Developments in Psychopharmacology
    |January 1, 1981
    PubMed
    Summary

    Anticonvulsant drugs can impair cognitive abilities, with phenytoin potentially causing insidious intellectual decline. Some anticonvulsants may improve behavior, but research on these effects is limited.

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    Area of Science:

    • Neuroscience
    • Pharmacology
    • Clinical Psychology

    Background:

    • Anticonvulsant medications are widely prescribed for epilepsy and other neurological disorders.
    • Potential adverse effects on behavior and cognition are a significant concern for patients and clinicians.
    • Existing research on these effects is limited, and evaluation methods are often inadequate.

    Purpose of the Study:

    • To review and synthesize the existing literature on the relationship between anticonvulsant drugs and disturbances in behavior and cognitive function.
    • To identify specific anticonvulsant drugs associated with cognitive impairment or behavioral changes.
    • To explore potential underlying mechanisms for these drug-induced effects.

    Main Methods:

    • Comprehensive literature review of studies investigating anticonvulsant drug effects on behavior and cognition.
    • Analysis of findings from psychological tests and clinical observations.
    • Discussion of potential neurobiological mechanisms, including alterations in folic acid and monoamine metabolism.

    Main Results:

    • Anticonvulsant drugs, as a class, can impair performance on cognitive and psychological tests.
    • Phenytoin, in particular, is linked to a progressive and often unrecognized decline in intellectual abilities.
    • Limited evidence suggests some anticonvulsants, like carbamazepine and sulthiame, may improve behavior, while others lack systematic behavioral data.

    Conclusions:

    • Anticonvulsant medications pose a risk of cognitive impairment, necessitating careful monitoring.
    • Phenytoin warrants particular attention due to its association with insidious intellectual decline.
    • Further systematic research is crucial to elucidate the behavioral effects of various anticonvulsants and their mechanisms, potentially involving folic acid and monoamine pathways.

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