Effects of vigabatrin on partial seizures and cognitive function.

Grünewald, R. A.; Thompson, Pamela J.; Corcoran, Rhiannon; Corden, Z.M.; Jackson, Graeme D.; Duncan, John S.

doi:10.1136/jnnp.57.9.1057

Cited by 62 publications

(44 citation statements)

References 27 publications

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“…Vigabatrin had no detrimental effects on cognitive functions at 12 months, and memory retrieval and mental flexibility improved significantly. One double-blind, placebo-controlled, randomized study reported impaired performance relating to motor speed and design learning in adolescents and adults with partial epilepsy [Grunewald et al 1994]. However, such negative effects were only reported in nonresponders who poorly tolerated the drug.…”

Section: Vigabatrinmentioning

confidence: 99%

“…These include refractory cases, patients with different kinds of epilepsy and younger or older patients. One study of vigabatrin reported CAEs in a relatively limited set of individuals classified as nonresponders [Grunewald et al 1994], although the characteristics of these individuals were poorly specified. Improvements in seizure control are particularly important in relation to attributing the cause of positive effects on cognition.…”

Section: Implications For Clinical Practicementioning

confidence: 99%

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The cognitive impact of antiepileptic drugs

Eddy¹,

Rickards²,

Cavanna³

2011

Ther Adv Neurol Disord

318

189

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Effective treatment of epilepsy depends on medication compliance across a lifetime, and studies indicate that drug tolerability is a significant limiting factor in medication maintenance. Available antiepileptic drugs (AEDs) have the potential to exert detrimental effects on cognitive function and therefore compromise patient wellbeing. On the other hand, some agents may serve to enhance cognitive function. In this review paper, we highlight the range of effects on cognition linked to a variety of newer and older AEDs, encompassing key alterations in both specific executive abilities and broader neuropsychological functions. Importantly, the data reviewed suggest that the effects exerted by an AED could vary depending on both patient characteristics and drug-related variables. However, there are considerable difficulties in evaluating the available evidence. Many studies have failed to investigate the influence of patient and treatment variables on cognitive functioning. Other difficulties include variation across studies in relation to design, treatment group and assessment tools, poor reporting of methodology and poor specification of the cognitive abilities assessed. Focused and rigorous experimental designs including a range of cognitive measures assessing more precisely defined abilities are needed to fill the gaps in our knowledge and follow up reported patterns in the literature. Longitudinal studies are needed to improve our understanding of the influence of factors such as age, tolerance and the stability of cognitive effects. Future trials comparing the effects of commonly prescribed agents across patient subgroups will offer critical insight into the role of patient characteristics in determining the cognitive impact of particular AEDs.

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Section: Vigabatrinmentioning

confidence: 99%

Section: Implications For Clinical Practicementioning

confidence: 99%

The cognitive impact of antiepileptic drugs

Eddy¹,

Rickards²,

Cavanna³

2011

Ther Adv Neurol Disord

318

189

View full text Add to dashboard Cite

show abstract

“…Six crossover studies 49,54,83,[85][86][87] and four parallel studies 38,[153][154][155] compared adjunctive VGB with placebo in patients with refractory seizures. In all but four of the trials, which involved patients with both generalised and partial seizures, 54,83,85,86 all patients had partial seizures.…”

Section: Figure 18 Proportion Of 50% Responders (Unpooled Rrs 95% CImentioning

confidence: 99%

“…However, details were lacking in 16 studies and four failed to provide details. [38][39][40] Two of these studies were only published in abstract form. 40,41 2.…”

mentioning

confidence: 99%

Clinical effectiveness, tolerability and cost-effectiveness of newer drugs for epilepsy in adults: a systematic review and economic evaluation

Wilby¹,

Kainth²,

Hawkins³

et al. 2005

Health Technol Assess

199

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. NHS libraries can subscribe free of charge. Public libraries can subscribe at a very reduced cost of £100 for each volume (normally comprising 30-40 titles). The commercial subscription rate is £300 per volume. Please see our website for details. Subscriptions can only be purchased for the current or forthcoming volume. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTA NHS R&D HTA ProgrammeT he research findings from the NHS R&D Health Technology Assessment (HTA) Programme directly influence key decision-making bodies such as the National Institute for Clinical Excellence (NICE) and the National Screening Committee (NSC) who rely on HTA outputs to help raise standards of care. HTA findings also help to improve the quality of the service in the NHS indirectly in that they form a key component of the 'National Knowledge Service' that is being developed to improve the evidence of clinical practice throughout the NHS.The HTA Programme was set up in 1993. Its role is to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined to include all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care, rather than settings of care.The HTA programme commissions research only on topics where it has identified key gaps in the evidence needed by the NHS. Suggestions for topics are actively sought from people working in the NHS, the public...

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“…In another parallel-group study of GBP, seizures in 5 of 18 patients taking placebo worsened during the treatment period (32). Similarly, increases in seizure frequency >50% were recorded in the placebo arms of trials of LTG (33) and VGB (34). Regression to the mean (or to the median) appears to be the most frequent reason for observed increases in seizure frequency in studies of the "before-and-after'' design (35).…”

mentioning

confidence: 99%

Do Antiepileptic Drugs Exacerbate Seizures?

Loiseau

1998

Epilepsia

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Effects of vigabatrin on partial seizures and cognitive function.

Cited by 62 publications

References 27 publications

The cognitive impact of antiepileptic drugs

The cognitive impact of antiepileptic drugs

Clinical effectiveness, tolerability and cost-effectiveness of newer drugs for epilepsy in adults: a systematic review and economic evaluation

Do Antiepileptic Drugs Exacerbate Seizures?

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