What the Research Shows: Cognition and Behavior

Use of anticonvulsants may also affect cognition and behavior in adults and children. The major cognitive effects of these medications are impaired attention, vigilance, and psychomotor speed, although memory and other cognitive variables may also be compromised.

In one study of the effects of phenobarbital, phenytoin, and valproate on healthy subjects, all three medications were shown to affect cognition, with phenobarbital cited as having the greatest impact. Among the newer drugs, topiramate has been identified as negatively affecting cognitive abilities, also in healthy volunteers, while gabapentin and lamotrigine appear to have less impact. In another comparative study of an older drug, carbamazepine, and a newer one, lamotrigine, the latter was found to have significantly fewer negative effects on cognition and behavior.

The Epilepsy Foundation has assembled an expert panel to study these issues and make recommendations for additional educational campaigns for both health care providers and people of all ages whose quality of life may be affected by medications.