Mind and behaviour in children and young adults with monotherapy of the antipeleptic drugs valproic acid, carbamazepine and sultiam

Objective: We testet cognition and behavior in children, adolescents and young adults with valproic acid (VPA), carbamazepine (CBZ) and sulthiam (SLT) before and after withdrawal. Methods: 26 persons in the age of 6–25 years with monotherapy of antiepileptic drugs have been examined with standard tests for intelligence and attention (Wechsler Intelligence Scale for children and adults (HAWIK/-E, d2-test of attention, figure-combination–test (ZVT)) and the child behaviour checklist (CBCL) or the young adult self report (YASR) before and after withdrawal of treatment. Results: HAWIK: The full scale IQ, performance IQ and verbal IQ didn't differ much by comparing the differences of the overall results before and after withdrawal of medication between the VPA- (n=16) the CBZ (n=7) and the SLT-group(n=4). The SLT-group improved in verbal comprehension factor (p=0.02 versus CBZ and VPA). The CBZ-group showed significant improvement in the subtest „object assembly „ (p=0.05 versus VPA and SLT). The VPA –group did better in the subtest „mazes“ (p=0.04 versus CBZ) after withdrawal of treatment. D2-test of attention and ZVT: There were no significantly different results between the three groups. CBCL/YASR: All three groups showed reduced behaviour disturbances after withdrawal of treatment by comparing the differences of the overall results. Significant differences could be found only between the CBZ- and the VPA-group (p=0.03). In addition, the CBZ group showed more signs of depression under medication than the SLT-group (p=0.04) and more attention problems than both groups (p=0.03 and 0.04). The SLT–group had more social problems after withdrawal than before (p=0.03 and 0.05) Conclusion: Although most results were similar for all groups, the medication showed some specific patterns of side-effects. We are in the process of recruiting more patients. (sponsored by Sanofi-Aventis, Berlin)