Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Epilepsy Behav. 2020 Dec;113:107580. doi: 10.1016/j.yebeh.2020.107580. Epub 2020 Nov 24.
Cognitive and psychiatric problems are common in people with epilepsy. They can have multiple causes, including structural brain lesions, the active epilepsy, and the effect of anti-epileptic therapy. Since patients' treatment compliance and quality of life are affected by cognitive and emotional status, it is crucial for clinicians to understand how anti-seizure medications (ASMs) affect cognition and mood, and to choose the proper ASM.
To conduct a literature review of the impact on cognition and mood status of lacosamide (LCM) in people with epilepsy.
Wesearched PubMed, the Cochrane Database of Systematic Reviews and reference lists of articles for all types of articles with no limitations on publication date.
A total of 251 records were obtained, including 247 articles in PubMed and 4 articles from reference lists. We included 2 meta-analyses, one randomized controlled trials and 14 observational studies after the screening process. Most studies agree LCM has low risk of treatment-emergent adverse events (TEAEs) on cognition. Comparisons with other ASMs, LCM may be preferable to carbamazepine, topiramate and perampanel, and not inferior to lamotrigine. In spite of low incident rate, depression is the most common psychiatric change of LCM. There are no consistent positive or negative psychiatric effects of LCM.
Lacosamide has limited impact on cognitive and mood status in this review. Several factors including mechanism of co-administration of ASMs and personal history of psychiatric disorder should be considered as important in the development of cognitive and psychiatric side effects. However, the heterogeneity between studies make the quality of evidence weaker and further trials are needed.
认知和精神问题在癫痫患者中很常见。它们可能有多种原因，包括结构性脑损伤、活动性癫痫和抗癫痫治疗的影响。由于患者的治疗依从性和生活质量受到认知和情绪状态的影响，临床医生了解抗癫痫药物（ASM）如何影响认知和情绪状态，并选择合适的 ASM 至关重要。
对拉科酰胺（LCM）对癫痫患者认知和情绪状态的影响进行文献综述。
我们在 PubMed、Cochrane 系统评价数据库和文章参考文献列表中搜索了所有类型的文章，没有出版日期的限制。
共获得 251 条记录，包括 PubMed 中的 247 篇文章和参考文献列表中的 4 篇文章。经过筛选，我们纳入了 2 项荟萃分析、1 项随机对照试验和 14 项观察性研究。大多数研究认为 LCM 对认知的治疗中出现的不良事件（TEAE）风险较低。与其他 ASM 相比，LCM 可能优于卡马西平、托吡酯和吡仑帕奈，且不劣于拉莫三嗪。尽管发生率较低，但抑郁是 LCM 最常见的精神科变化。LCM 没有一致的积极或消极的精神科影响。
在本综述中，拉科酰胺对认知和情绪状态的影响有限。在认知和精神副作用的发展中，应考虑包括 ASM 联合用药机制和个人精神病史在内的几个因素。然而，研究之间的异质性使证据质量减弱，需要进一步的试验。
