Evaluating the longer-term cognitive effects of adjunctive perampanel compared to lacosamide in a naturalistic outpatient setting

Meschede, Carolin; Witt, Juri‐Alexander; Rademacher, Michael; Wrede, Randi von; Elger, Christian E.; Helmstaedter, Christoph

doi:10.1016/j.seizure.2018.04.015

Cited by 40 publications

(25 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Likewise those authors also noted that only 0.9-2.6% of their patients discontinued PER because of aggression that emerged during treatment, which was confirmed by the present results. Furthermore, in another study that included naturalistic clinical settings, the rise of irritability or aggression was reported to be negated [14]. The findings of Liguori et al agreed with those and emphasized that psychiatric issues are less conspicuous in patients receiving PER as compared to those given levetiracetam [4].…”

Section: Discussionmentioning

confidence: 74%

The effect of perampanel on aggression and depression in patients with epilepsy: A short-term prospective study

Goji

Kanemoto

2019

Seizure

View full text Add to dashboard Cite

A B S T R A C TPurpose: Using specialized tools, we assessed patients receiving perampanel (PER) to investigate its effects on aggression and depression, as well as the impact of other concomitant antiepileptic drugs (AEDs) on those conditions. Method: Seventy-seven patients with epilepsy were initially enrolled, then examined at entry and 12 weeks later (endpoint). At both examinations, assessments were performed with the Buss Perry Aggression Questionnaire (BAQ) and Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). Ultimately, 59 patients completed the study. Results: Total BAQ (p = 0.013) and NDDI-E (p = 0.000) scores at the endpoint were significantly increased in comparison with those at entry. Analysis with 4 subscales showed increases in both verbal and physical aggression, while multivariate analysis revealed that concomitant AED administration did not have a significant impact on the increase of BAQ or NDDI-E score. A dose-dependent effect of PER was confirmed in BAQ, but not NDDI-E results. PER was discontinued due to adverse psychiatric effects in 3.9% of the patients. Conclusions: The present findings indicate that PER increases assessment scores indicative of aggression as well as depression. No additional aggression-augmenting effect was seen with concomitant AED administration.

show abstract

Section: Discussionmentioning

confidence: 74%

The effect of perampanel on aggression and depression in patients with epilepsy: A short-term prospective study

Goji

Kanemoto

2019

Seizure

View full text Add to dashboard Cite

show abstract

“…Practice corrected RCIs indicate a significant change with a gain of > 3 points, and a loss of > 2 points. Studies demonstrated the usefulness of the Epi-Track with regard to cognitive monitoring of pharmacological treatments [8,9,16,17] and its sensitivity in regard to the overall drug load, i.e. the number of concurrent AEDs [18].…”

Section: Attention and Executive Functionmentioning

confidence: 99%

“…At the epilepsy center in Bonn we have established a routine monitoring of the cognitive and behavioral effects of drug treatment in in-T and outpatients that is following a natural schedule as requested by the treating physician [8,9].…”

Section: Introductionmentioning

confidence: 99%

Short-term and longer-term effects of brivaracetam on cognition and behavior in a naturalistic clinical setting—Preliminary data

Witt

Elger

Helmstaedter

2018

Seizure

Self Cite

View full text Add to dashboard Cite

To assess short-term and longer-term effects of brivaracetam (BRV) on cognition and behavior in a naturalistic clinical setting. Methods: Analyses were based on 43 patients with epilepsy who had undergone a neuropsychological screening before adjunctive treatment with BRV and a follow-up evaluation either after 5 days or 25 weeks. The standard assessment focused on reaction times (Neurocog FX), attention and executive functions (EpiTrack), and verbal memory (short version of the VLMT). Self-perceived cognition and behavior was evaluated by an extended version of the Adverse Events Profile. In addition, health-related quality of life (QOLIE-10) was reassessed at the longer-term interval. Results: Repeated measures analysis of variance revealed a significant improvement under BRV with regard to attention and executive functions (p = .03) without an interaction with the length of the observation interval. A statistical trend in the same direction was also seen for the reaction times (p = .07), but not for the unchanged verbal memory performance. Subjective measures indicated improvements in concentration (p = .02) and especially in comprehension (p < .001), and health-related quality of life (p = .002). Mood and aggression scores were unchanged. At the longer-term follow-up, an at least 50 percent reduction in seizure frequency was observed in 53% of the patients, 21% were seizure free. Conclusion: These preliminary data point to a favorable cognitive profile of BRV similar to its precursor levetiracetam. Objective gains in attention and executive functions were accompanied by self-reported improvements in concentration and comprehension. Future studies with larger sample sizes and better control conditions are needed to confirm these findings.

show abstract

“…Anxiety was not significantly affected by lacosamide, but was measured with a 7‐item tool in only 20 of these patients. Lacosamide was found to not deteriorate cognition and in some cases even to improve it in a German study of long‐standing adult epilepsy patients . In contrast, a systematic review observed controversial effects on mood and cognition in pediatric populations .…”

mentioning

confidence: 95%

“…Lacosamide was found to not deteriorate cognition and in some cases even to improve it in a German study of long-standing adult epilepsy patients. 19 In contrast, a systematic review observed controversial effects on mood and cognition in pediatric populations. 20 In another open, multicenter study of patients with treatmentresistant focal epilepsy, lacosamide improved scores on the Beck Depression Inventory-II in the entire sample of 49 patients aged more than 16 years, and improved anxiety symptoms in patients with anxiety, independently from their improvement in epilepsy.…”

mentioning

confidence: 99%

Lacosamide in bipolar disorder: A 30‐day comparison to a retrospective control group treated with other antiepileptics

Cuomo

Piacentino

Kotzalidis

et al. 2018

Psychiatry Clin Neurosci

View full text Add to dashboard Cite

Aim Bipolar disorder (BD) is often treated with anticonvulsants. Lacosamide has not been tested in BD. We assessed its effects in a hospital setting in patients with BD without epilepsy. Methods We treated 102 consecutive hospitalized patients with acute BD with lacosamide 50–300 mg/day. We compared this sample with a retrospective sample treated with other antiepileptics (OAE). We rated patients after 3, 7, 15, and 30 days of treatment with the Brief Psychiatric Rating Scale, Young Mania Rating Scale, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Clinical Global Impressions – Severity, and Global Assessment of Functioning. Results Patients receiving lacosamide were significantly younger and had fewer mixed episodes at intake, and less substance use disorder comorbidity than those receiving OAE. Both groups showed positive effects on all measures. The two groups did not differ on any clinical measure at baseline, but from the 3rd day on, lacosamide patients fared better than OAE patients on the Young Mania Rating Scale and Clinical Global Impressions – Severity and worse on the Hamilton Anxiety Rating Scale. From the 15th day, OAE patients scored better on the Brief Psychiatric Rating Scale. Global Assessment of Functioning scores were significantly more improved in the lacosamide patients. Age, substance use disorder comorbidity, episode type, and educational level significantly affected results. No interactions were found amongst these parameters. Conclusion Lacosamide was effective in reducing psychopathology, mania, depression, and anxiety and in improving global functioning in patients with BD‐I/II disorder in the short term, with few side‐effects. Lacosamide improved mania, clinical severity, and global functioning better than OAE at doses lower than those used in epilepsy.

show abstract

Evaluating the longer-term cognitive effects of adjunctive perampanel compared to lacosamide in a naturalistic outpatient setting

Abstract: In a naturalistic outpatient setting, chronic adjunctive treatment with PER and LCM did not negatively affect cognition and LCM may even improve cognition. Neither drug increased self-reported irritability or aggression. This suggests favorable longer-term tolerability.

Cited by 40 publications

References 31 publications

The effect of perampanel on aggression and depression in patients with epilepsy: A short-term prospective study

The effect of perampanel on aggression and depression in patients with epilepsy: A short-term prospective study

Short-term and longer-term effects of brivaracetam on cognition and behavior in a naturalistic clinical setting—Preliminary data

Lacosamide in bipolar disorder: A 30‐day comparison to a retrospective control group treated with other antiepileptics

Contact Info

Product

Resources

About