Table 4.
Studies on the cognitive effects of levetiracetam in patients with epilepsy.
Study | Design | Sample | Key findings |
---|---|---|---|
Huang et al. [2008] | SB, comparing LEV and TPM | 79 adults with partial epilepsy | No difference between AEDs using cognitive abilities screening instrument. There were slightly more cognitive complaints with TPM. |
Gomer et al. [2007] | OL, comparing LEV and TPM | 52 adults with partial epilepsy | No CAEs on tests of cognitive speed, verbal fluency and short-term memory with LEV, but differences for TPM. Cognitive performance not related to dose. |
Levisohn et al. [2009] | DB, PC, rand | 120 child and adolescent patients | CAEs were reported more frequently for LEV versus placebo (9.4% vs. 2.9). These included memory and attentional problems. |
Piazzini et al. [2006] | OL, cont, add-on | 35 adults with treatment-resistant partial epilepsy, 35 similar controls on usual treatment | Significant improvements in attention and verbal fluency were seen with the addition of LEV. |
Neyens et al. [1995] | SB, add-on | 10 adult patients taking CBZ or PHT | No cognitive differences with LEV on tasks involving attention, memory and information processing. |
Wheless and Ng [2002] | OL, add-on | 39 child patients | Improvements in cognition/concentration (13%) and alertness (13%) were reported by some patients. In some patients these effects seemed unrelated to seizure control. |
Von Stülpnagel et al. [2010 | OL | 32 children with benign idiopathic partial epilepsies of childhood | According to parent interview, cognition improved in 10/32 patients and worsened in none. Improved cognition was reported in cases showing reduced seizures. |
Helmstaedter and Witt [2010] | OL, comparing LEV and CBZ | 498 adult patients | Patients taking LEV rated their cognitive status as improved and showed improvements on verbal learning and memory tasks. |
Cramer et al. [2000] | DB, PC, rand, add-on | 246 adults with partial-onset seizures | Cognitive functioning was reported as improved on a quality-of-life measure in comparison with placebo. |
Wu et al. [2009] | OL | 94 adults with generalized tonic–clonic or partial-onset seizures | Mini-Mental State Examination scores improved by 1 year, including most significant improvement for short-term memory recall and language. |
Ciesielski et al. [2006] | OL, add-on, comparing LEV and PGB | 20 adults with treatment-resistant partial epilepsy | Trend for improvement in visual short-term memory with LEV, but no significant differences for attention, working memory or executive function tasks. No significant differences between AEDs for cognition. |
López-Góngora et al. [2008] | OL, add-on | 32 adult patients | Evidence of improvements in working memory, verbal fluency, motor functioning, attention and prospective memory. |
Rosche et al. [2004] | Retro, comparing LEV and TPM | 39 adult patients | Minor improvements in cognition for LEV but not TPM. Improved digit span and fluid intelligence scores. |
Helmstaedter et al. [2008] | OL, cont | 288 adult patients, 43 patients on usual medication | Reports of improved psychomotor speed, concentration, and remote memory. Such effects were not related to type of epilepsy, cotherapy, dose, drug load or psychiatric history. |
Zhou et al. [2008] | DB, PC, rand, then OL | 28 adults with partial-onset seizures | Better set-shifting and delayed logic memory soon after treatment. Improved verbal fluency, attention and other aspects of memory. Improved cognition according to quality-of-life measure. |
Lippa et al. [2010] | OL | 24 elderly patients with cognitive impairment | Improved Mini-Mental State Examination score and cognitive functioning according to Alzheimer’s Disease Assessment Scale. |
AEDs, antiepileptic drugs; CAEs, cognitive adverse effects; CBZ, carbamazepine; cont, controlled; DB, double-blind; ETX, ethosuximide; GBP, gabapentin; HCs, healthy controls; LTG, lamotrigine; OL, open-label; OXC, oxcarbazepine; PC, placebo-controlled; PHB, phenobarbital; PHT, phenytoin; rand, randomized; retro, retrospective; SB, single-blind; TPM, topiramate; VGB, vigabatrin; VPA, sodium valproate.