Abstracts

Rationale: In the last decade many new anti-epileptic drugs (AEDs) were introduced to the market, especially for patients with medically refractory epilepsy. However, as with any medication, side effects are commonly reported upon initiation of treatment with a new AED. Although these side effects may reflect actual physiologic reactions to the drug, psychological factors also significantly affect a patient s reaction to new medication. The placebo effect can work both ways, in promoting a positive response to new therapy or in reflecting perceived side effects in patients with psychological difficulties. The current study examines the effects of mood disorders on reported side effects to AEDs in an epilepsy sample. Methods: A cross-sectional analysis was done to determine the relationship between the side effect profile and respective BDI & BAI scores. Subjects referred for neuropsychological testing were included. Their side effect profile was derived from our review of systems (ROS) collected at each visit. The side effect profile was divided into 4 categories: cognitive/coordination (i.e., dizziness), mood/emotion, sleep, cephalgia , systematic complaints (i.e., rash/eye pain) which was based on the commonly used Adverse Effect Profile (Gilliam, 2003). BDI (n=59) and BAI (n=54) scores were categorized into 4 quartiles. Individuals in the 1st and 4th quartiles were included (those missing ROS were excluded). The number of AEDs was factored into the analysis. Chi squared and t tests were performed where appropriate Results: There was a significant difference in the mean BDI and BAI scores between the 1st and 4th Quartile (P<0.05). Between the 1st and 4th Quartile, there was a significant difference in mood, sleep, cephalgia and systemic complaints for the BDI groups, and cognition/coordination, mood, sleep and cephalgia for the BAI groups. These differences remained significantly different after controlling for the number of AEDs (see table for additional statistical findings).