Bourgeois B
Department of Neurology, Washington University, St. Louis, MO 63110.
Praxis (Bern 1994). 1994 Oct 4;83(40):1122-5.
In patients with epilepsy, cognitive functions can be affected by several factors individually or in combination. These complex interactions between various factors have been responsible for considerable methodological problems in the assessment of the effect of individual antiepileptic drugs on cognitive functions. A discussion on the effect of sodium valproate on cognitive functions should consider three aspects: whether valproate affects cognitive functions, how possible cognitive effects of valproate compare with those of other antiepileptic drugs, and finally whether valproate has a positive psychotropic effect. A suspected specific psychotropic effect of valproate could not be confirmed. The majorities of the studies in which the cognitive effects of valproate were assessed are comparative studies with other antiepileptic drugs in treated patients; however, some studies were based on the introduction or the discontinuation of valproate monotherapy or on a comparison between a high dose and a low dose. Like other antiepileptic drugs, sodium valproate can affect cognitive functions and behavior. When valproate has been compared with other antiepileptic drugs, the results have been either equal or in favor of valproate; however, overall these cognitive and behavioral effects are rather mild also for the other antiepileptic drugs and have been slightly overrated in the past.
在癫痫患者中,认知功能可能会受到多种因素单独或共同的影响。这些不同因素之间的复杂相互作用导致了在评估个别抗癫痫药物对认知功能影响时出现了相当多的方法学问题。关于丙戊酸钠对认知功能的影响的讨论应考虑三个方面:丙戊酸钠是否影响认知功能,丙戊酸钠可能的认知影响与其他抗癫痫药物相比如何,以及最后丙戊酸钠是否具有积极的精神otropic作用。丙戊酸钠疑似的特定精神otropic作用尚未得到证实。大多数评估丙戊酸钠认知影响的研究是在接受治疗的患者中与其他抗癫痫药物进行的比较研究;然而,一些研究是基于丙戊酸钠单药治疗的引入或停用,或者基于高剂量和低剂量之间的比较。与其他抗癫痫药物一样,丙戊酸钠会影响认知功能和行为。当将丙戊酸钠与其他抗癫痫药物进行比较时,结果要么相同,要么有利于丙戊酸钠;然而,总体而言,这些认知和行为影响对其他抗癫痫药物来说也相当轻微,并且在过去被略微高估了。