Preschool behavioral problems in children prenatally exposed to antiepileptic drugs — A follow-up study

Introduction/Objective. The aim of this follow-up study was to determine the effects of topiramate therapy on cognitive functions in patients with pharmacoresistant focal epilepsy. Methods. The study sample comprised of 40 topiramate naive patients. The topiramate starting dose was 25 mg, with a fortnightly titration schedule of 25 mg. A wide range of cognitive functions was evaluated through extensive neuropsychological testing at baseline and six months after reaching the target dose (200 mg/day). Results. The most common side effects following the introduction of topiramate were cognitive impairments, reported by 45% of the participants. The neuropsychological scores on attention, executive function, verbal content recall, improved cognitive flexibility, as well as visuospatial ability and speech, obtained at six-month follow-up were significantly lower than at baseline. However, statistically significant correlation between neuropsychological scores and the number of antiepileptic drugs taken alongside topiramate could not be established. Similarly, no statistically significant differences were noted between the percentage of reduced neuropsychological scores at follow-up pertaining to patients with lower and higher baseline cognitive performance. Moreover, regression analysis indicates that the percentage change in the majority of cognitive scores is unrelated to the age at the epilepsy onset, epilepsy duration, presence of brain pathology on magnetic resonance imaging and percentage change in the depression scale score. Conclusion. Despite slow introduction and administration of a relatively small dose, topiramate exhibits adverse effects on a wide range of cognitive functions, which appear unrelated to the number of additional antiepileptic drugs, baseline cognitive functioning, age at the onset of epilepsy and its duration, presence of brain pathology and the extent of depressive symptoms.

Download Full-text

The relationship of anxiety, depression and behavioral problems with recurrent headache in late adolescence – a Young-HUNT follow-up study

The Journal of Headache and Pain ◽

10.1186/1129-2377-16-10 ◽

2015 ◽

Vol 16 (1) ◽

Cited By ~ 32

Author(s):

Brit A Blaauw ◽

Grete Dyb ◽

Knut Hagen ◽

Turid L Holmen ◽

Mattias Linde ◽

...

Keyword(s):

Behavioral Problems ◽

Late Adolescence ◽

Recurrent Headache ◽

Follow Up Study ◽

Relationship Of ◽

Anxiety Depression ◽

The Relationship

Download Full-text

Severity of Autism Symptoms and Degree of Attentional Difficulties Predicts Emotional and Behavioral Problems in Children with High-Functioning Autism; a Two-Year Follow-up Study

Frontiers in Psychology ◽

10.3389/fpsyg.2017.02004 ◽

2017 ◽

Vol 8 ◽

Cited By ~ 3

Author(s):

Per N. Andersen ◽

Kjell T. Hovik ◽

Erik W. Skogli ◽

Merete G. Øie

Keyword(s):

Behavioral Problems ◽

High Functioning Autism ◽

Emotional And Behavioral Problems ◽

Autism Symptoms ◽

High Functioning ◽

Follow Up Study ◽

Attentional Difficulties

Download Full-text

Risk of early neurodevelopmental outcomes associated with prenatal exposure to the antiepileptic drugs most commonly used during pregnancy: a French nationwide population-based cohort study

BMJ Open ◽

10.1136/bmjopen-2019-034829 ◽

2020 ◽

Vol 10 (6) ◽

pp. e034829 ◽

Cited By ~ 2

Author(s):

Pierre-Olivier Blotière ◽

Sara Miranda ◽

Alain Weill ◽

Yann Mikaeloff ◽

Hugo Peyre ◽

...

Keyword(s):

Cohort Study ◽

Antiepileptic Drugs ◽

Prenatal Exposure ◽

Neurodevelopmental Disorders ◽

Population Based ◽

Prenatally Exposed ◽

Neurodevelopmental Outcomes ◽

Increased Risk ◽

Speech Therapists

ObjectivesTo assess the association between prenatal exposure to monotherapy with the antiepileptic drugs (AEDs) most commonly used during pregnancy and the risk of various neurodevelopmental outcomes compared with lamotrigine.DesignNationwide population-based cohort study.SettingFrench national healthcare databases.ParticipantsChildren born alive between 2011 and 2014 and prenatally exposed to AED monotherapy.Primary and secondary outcome measuresOutcomes included neurodevelopmental disorders (NDD), defined by International Classification of Diseases, 10th Revision codes F70-F98—pervasive developmental disorders (PDD, F84) and mental retardation (MR, F70-F79) were studied separately—and visits to speech therapists. The reference group comprised children prenatally exposed to lamotrigine. Children were followed until outcome, loss to follow-up, death or 31 December 2016. We performed inverse probability of treatment weighting analyses using the propensity score, which included maternal and infant characteristics. Hazard ratios (HRs) were calculated using Cox models.ResultsThe cohort comprised 9034 children, 2916 of which were exposed to lamotrigine, 1627 to pregabalin, 1246 to clonazepam, 991 to valproic acid (VPA), 621 to levetiracetam, 502 to carbamazepine, 477 to topiramate, 378 to gabapentin and 143 to oxcarbazepine. None of these AEDs, except VPA, was associated with an increased risk of any of the four neurodevelopmental outcomes investigated. Exposure to VPA was associated with increased risks of NDDs (HR=2.7, 95% CI (1.8 to 4.0)), PDD (HR=4.4 (2.1 to 9.3)), MR (HR=3.1 (1.5 to 6.2)) and visits to speech therapists (HR=1.5 (1.1 to 1.9)), with a dose-response relationship.ConclusionsNo increased risk of any of the neurodevelopmental outcomes investigated in this study was observed with prenatal exposure to levetiracetam, pregabalin, oxcarbazepine, topiramate, gabapentin, clonazepam or carbamazepine, compared with lamotrigine. However, this study corroborates the well-known association between maternal use of VPA during pregnancy and the risk of neurodevelopmental disorders in the offspring. Longer follow-up is necessary to confirm these findings.

Download Full-text