Cognitive side effects of antiepileptic drugs

Antiepileptic drugs produce global changes in the excitation levels in the central nervous system and often lead to cognitive and behavioral deficits. These deficits vary and must be considered independently in every patient. A number of consistent risk factors have been established. Polypharmacy and high blood levels of an antiepileptic drug (AED) increase the risk of cognitive side effects. Different effects have been demonstrated for some AEDs, but comparative data are incomplete across all of them. Other factors such as patient age and type/frequency of seizures may also be important contributors to the patient's cognitive state. AEDs can have positive or negative effects on mood, providing another consideration in choosing the course of treatment. (C) 2003 Elsevier Inc. All rights reserved.