Abstracts

Rationale: In antiepileptic drug intervention, unwanted cognitive and affective side effects may seriously compromise the patient`s quality of life, his compliance and his ability to work. Therefore, individual cognitive and mood changes should be tracked through the course of drug therapy. Lacosamide is one of the newer antiepileptic drugs used in the treatment for partial-onset seizures. In this study, cognitive and mood side effects of add-on therapy with lacosamide were investigated. Methods: 18 epilepsy patients were investigated. In addition to their pre-existing, stable antiepileptic medication, lacosamide was titrated as an add-on therapy. The patients underwent an examination of their cognitive and affective functions before add-on of lacosamide and three months after. The computerized neuropsychological test battery (CCTE) covered the cognitive domains of attention, cognitive speed, working memory, verbal and figural memory. Emotional variables like depression, anxiety, irritability, sleep quality and subjective performance were recorded by means of visual scales. Results: No significant changes of the patients` cognitive and mood profile related to the add-on of lacosamide could be detected. Comparing the two examinations before and after titration of lacosamide, median to high correlations were proven for all subtests of cognitive performance (p<0.05) and affective state (p<0.01). In most cognitive subtests a slight but not significant improvement was shown, which might be interpreted as practice effect. Conclusions: The results show that with lacosamide as an add-on antiepileptic therapy, no significant changes occur in the cognitive or mood profile. It indicates that, concerning cognitive and affective side effects, lacosamide as an add-on medication is a well-tolerated antiepileptic drug and is unlikely to impair cognition and mood. In general, a regular neuropsychological assessment of these functions is essential to keep track of unwanted side effects of antiepileptic medication and to optimize therapeutic interventions.