Abstract Details

Title Comparative Neuropsychological Effects of Carbamazepine and Eslicarbazepine Acetate

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 6-010

Objective To compare neuropsychological effects of eslicarbazepine acetate (ESL), and carbamazepine (CBZ).

Background Patients with epilepsy are at increased risk for neuropsychological dysfunction due to multiple factors. Of these, antiseizure medications (ASMs) are among the most important and potentially amendable. ASM effectiveness is frequently determined by tolerability.

Design/Methods A randomized, double-blind, crossover design in healthy volunteers was employed with 2-week titration and 4-week maintenance phase in each treatment arm. Use of healthy volunteers avoids confounding effects of changes in seizures, facilitates crossover design, provides generalization to different disease states, and allows comparison to similar prior studies. Target dosages: CBZ=400mg BID and ESL=800mg qAM. Neuropsychological testing was performed at initial visit to familiarize subjects with tasks, and repeated at 1^stbaseline non-drug condition, end treatment #1, 2nd non-drug condition one-month after treatment #1, end treatment #2, and 3^rdnon-drug condition one-month after treatment #2. Neuropsychological testing was conducted 2-hours after morning dose and included computer (ie, 1- & 2-back continuous performance, dual task, selective attention, symbol digit, verbal memory, visuospatial memory) and non-computer tasks (ie, MCG paragraph memory, Stroop, Symbol Digit, Profile of Mood States). Z-scores calculated from non-drug conditions were used to calculate omnibus scores to compare ESL and CBZ. Follow-up analyses of test scores and distribution of individual raw means were done.

Results

23 subjects completed the study: 16 men, mean age=38 yo (range=22-55), mean IQ=98 (SD=9). Mean blood levels on test day were CBZ=8.9 (range 4-12) and ESL=15.3 (range 3-35). The Omnibus Z-score revealed significantly better scores for ESL (p=0.000). For individual measures, executive function and selective attention tests were statistically significant better for ESL. The individual test raw means favored ESL over CBZ on 19 of the 27 measures (p=.0146, 2-tailed sign test).

Conclusions ESL demonstrated less adverse neuropsychological effects than CBZ. These findings may be helpful when choosing ASMs.

Authors/Disclosures
Kimford J. Meador, MD, FAAN (Stanford University School of Medicine) PRESENTER	The institution of Dr. Meador has received research support from NIH. The institution of Dr. Meador has received research support from The Epilepsy Consortium.
Jordan Seliger	Jordan Seliger has nothing to disclose.
Babak Razavi, MD, PhD (Stanford University Medical Center)	Dr. Razavi has stock in CortexXus. The institution of Dr. Razavi has received research support from Neuropace.
	No disclosure on file
Scheherazade Le, MD (Stanford University)	Dr. Le has nothing to disclose.
David W. Loring, PhD, FAAN	Dr. Loring has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. Dr. Loring has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for ILAE. The institution of Dr. Loring has received research support from NIH. Dr. Loring has received publishing royalties from a publication relating to health care.

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