Manara - Qatar Research Repository
Browse
1/1
3 files

Dosage, time, and polytherapy dependent effects of different levetiracetam regimens on cognitive function

journal contribution
submitted on 2024-02-01, 09:55 and posted on 2024-02-01, 09:56 authored by Jon Davis Perkins, Mohamed S. Abdelmoneim, Stacy Schantz Wilkins, Saadat Kamran, Boulenouar Mesraoua, Gayane Melikyan, Abdulraheem Alrabi, Ahmed El-Bardissy, Osama Elalamy, Hassan Jassim Al Hail

Objective

Cognitive impairment is a potential drawback of antiseizure medications. This study aimed to evaluate the impact of different levetiracetam drug regimens on cognitive function.

Methods

A retrospective analysis identified 221 patients diagnosed with seizures who underwent cognitive screening. Patients were categorized into four groups: no medications, non-levetiracetam medications, high and low dose levetiracetam. Composite scores determined low and high levetiracetam groups whereby one point was added for each increment in dosage, duration since uptake, and concurrent anti-seizure medication. Variables known to affect cognition were recorded and classified as demographic, seizure-related, diagnosis-related, and psychopathology. Logistic regression was used to identify variables associated with cognitive scores below cut-off.

Results

Multivariable analysis found being male, non-active in the community, less than 12 years of education, left temporal lobe epilepsy, high seizure frequency, and depression were associated with poor cognitive performance. In a final regression analysis, the high levetiracetam group exhibited a 4.5-fold higher likelihood of scoring below cut-off than the medication-free group (OR 4.5, CI 1.5–13.6, p<.08). Depression (OR 2.1, CI 1.1-3.9, p<.03), being male (OR 2.2, CI 1.1-4.3, p<.02), and not being active in the community (OR 3.8, 1.6-8.7, p <.003) remained significant contributors to the model. Language (p<.05), attention (p<.05), and delayed recall (p<.001) were the most affected cognitive domains.

Significance

When taken in small doses, for brief periods as monotherapy, levetiracetam minimally influences cognition.

At higher doses, as part of long-term seizure management, in conjunction with multiple ASMs, LEV is associated with cognitive impairment.

Other Information

Published in: Epilepsy & Behavior
License: http://creativecommons.org/licenses/by/4.0/
See article on publisher's website: https://dx.doi.org/10.1016/j.yebeh.2023.109453

Funding

Open Access funding provided by the Qatar National Library.

History

Language

  • English

Publisher

Elsevier

Publication Year

  • 2023

License statement

This Item is licensed under the Creative Commons Attribution 4.0 International License.

Institution affiliated with

  • Hamad Medical Corporation
  • Weill Cornell Medicine - Qatar

Usage metrics

    Hamad Medical Corporation

    Licence

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC