Meador K J, Loring D W, Ray P G, Murro A M, King D W, Nichols M E, Deer E M, Goff W T
Department of Neurology, Medical College of Georgia, Augusta 30912, USA.
Epilepsia. 1999 Sep;40(9):1279-85. doi: 10.1111/j.1528-1157.1999.tb00858.x.
The cognitive effects of the newer antiepileptic drugs (AEDs) compared with the older standard AEDs are uncertain.
We directly compared the cognitive effects of carbamazepine (CBZ) and gabapentin (GBP) in 35 healthy subjects by using a double-blind, randomized crossover design with two 5-week treatment periods. During each treatment condition, subjects received either GBP, 2,400 mg/day, or CBZ (mean, 731 mg/day) adjusted to a dose to achieve midrange standard therapeutic blood levels (mean, 8.3 microg/ml). Subjects were tested at the end of each AED treatment period and in four drug-free conditions [two pretreatment baselines and two post-treatment washout periods (1 month after each AED)]. The neuropsychological test battery included 17 measures yielding 31 total variables.
Direct comparison of the two AEDs revealed significantly better performance on eight variables for GBP, but none for CBZ. Comparison of CBZ and GBP to the nondrug average revealed significant statistical differences for 15 (48%) of 31 the variables. Pairwise follow-up analyses of the 15 variables revealed significantly better performance for nondrug average on 13 variables compared with CBZ, and on four compared with GBP. GBP was better than nondrug average on one variable.
Although both CBZ and GBP produced some effects, GBP produced significantly fewer untoward cognitive effects compared with CBZ at the dosages used in this study.
与传统标准抗癫痫药物（AEDs）相比，新型AEDs的认知影响尚不确定。
我们采用双盲、随机交叉设计，设置两个为期5周的治疗期，对35名健康受试者直接比较卡马西平（CBZ）和加巴喷丁（GBP）的认知影响。在每个治疗阶段，受试者接受2400毫克/天的GBP或调整剂量以达到标准治疗血药浓度中值（平均8.3微克/毫升）的CBZ（平均731毫克/天）。在每个AED治疗期结束时以及四个无药状态下（两个治疗前基线期和两个治疗后洗脱期，每个AED治疗后1个月）对受试者进行测试。神经心理测试组合包括17项测量指标，共产生31个变量。
两种AEDs的直接比较显示，GBP在8个变量上表现明显更好，而CBZ则无。将CBZ和GBP与非药物状态平均值比较，31个变量中有15个（48%）存在显著统计学差异。对这15个变量进行两两后续分析发现，与CBZ相比，非药物状态平均值在13个变量上表现明显更好，与GBP相比在4个变量上表现明显更好。GBP在一个变量上比非药物状态平均值更好。
虽然CBZ和GBP都产生了一些影响，但在本研究使用的剂量下，与CBZ相比，GBP产生的不良认知影响明显更少。
