The Effects of Antiepileptic Drugs on Pediatric Cognition, Mood, and Behavior

Abstract

In the past three decades, several new antiepileptic drugs (AEDs) have been marketed across the world, although with a surprisingly modest improvement in overall seizure control. During the same period, the use of AEDs as mood stabilizing or impulse control agents has been trending upwards, due to a notable increase in comorbid mood and behavior disorders in children, and a desire to address these pharmacologically. AEDs have been frequently associated with adverse mood and behavior changes, along with neuropsychiatric effects on attention, memory, and cognition. In this review, we discuss the use and adverse effects of the first- (e.g., barbiturates, carbamazepine, ethosuximide, phenytoin, valproate), second- (e.g., clobazam, felbamate, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, pregabalin, tiagabine, topiramate, stiripentol, vigabatrin, zonisamide), and third- (e.g., brivaracetam, eslicarbazepine acetate, lacosamide, perampanel, retigabine, rufinamide) generation AEDs in pediatric mood and behavior disorders. We also address what is currently known about the potential long-term neuropsychiatric consequences of AEDs. The distinction between the U.S. Food and Drug Administration-approved drugs versus off-label use of these drugs in the pediatric population is also examined.Copyright © 2017 by Georg Thieme Verlag KG, Stuttgart, New York.