Affiliations: [a] Department of Surgery (Neurosurgery), Medical College of Georgia, Augusta, GA 30912-4010, USA | [b] Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta, GA 30912-4010, USA | [c] Section of Behavioral Neurology, Department of Neurology Medical College of Georgia, Augusta, GA 30912-4010, USA | Stroke Rehabilitation Services, Department of Physical Medicine and Rehabilitation, Medical College of Virginia, Richmond, Virginia, USA
Correspondence:
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Corresponding author, Section of Neurosurgery, Medical College of Georgia, Augusta, GA 30912-4010, USA. Tel.: (706) 721 7883; Fax: (706) 721 7256.
Abstract: Antiepileptic drugs (AEDs) are used in rehabilitation patients with injury to the nervous system for control of clinical seizures, prophylaxis against the development of a seizure disorder, and treatment of secondary mania. Although most AEDs can produce mild cognitive side effects, the benefits of treatment with AEDs in rehabilitation patients with seizure disorders typically outweigh these minor risks, Bromide, phenobarbital, and benzodiazepines may have more severe cognitive side effects than other AEDs. However, there is no convincing evidence of clinically significant differences in cognitive adverse effects among the other established AEDs. Furthermore, cognitive side effects are usually modest with mono therapy and anticonvulsant blood levels within standard therapeutic ranges. With regard to prophylaxis against future seizures, there is no significant data indicating that AED administration can prevent or retard the process of epileptogenesis, Therefore, the use of AEDs to prevent the development of a seizure disorder is not warranted at this time. Finally, although there is little information about the behavioral effects of anticonvulsants in neurological rehabilitation patients, the efficacy of carbamazepine, and perhaps valproate, in the treatment of primary mania suggests that these AEDs may be beneficial in mania secondary to brain injury. The role of AEDs in the treatment of other psychiatric disorders, such as post-traumatic stress disorder and episodic dyscontrol, remains unclear.
