Effects of pertuzumab and trastuzumab: A Synthesis of Findings from 11 Studies

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Original Abstract of the Article

Main Research Findings

Several studies have investigated the effects of phenytoin on cognitive function, particularly in the context of epilepsy treatment. One study found that phenytoin negatively impacted visual motor speed and memory performance compared to carbamazepine in patients with newly diagnosed epilepsy. 3 Another study observed impaired cognitive performance, particularly in motor and speed tasks, in patients receiving phenytoin for posttraumatic seizures. 1 However, in children with well-controlled seizures, phenytoin in low therapeutic doses did not significantly impact psychomotor performance, even with fluctuations in drug levels. 5 Importantly, a separate study indicated that phenytoin might slow EEG peak frequency and increase theta and delta power, which could potentially correlate with cognitive function. 10 Additionally, a study comparing phenytoin and valproic acid for newly diagnosed tonic-clonic seizures found that both drugs were effective in preventing seizure recurrence, with mild side effects. 2

Benefits and Risks

Benefit Summary

Phenytoin has proven to be effective in preventing and treating epileptic seizures. 8 , 2 This benefit applies particularly to preventing posttraumatic seizures. 1 When used within the therapeutic range, phenytoin may not negatively impact cognitive function. 7

Risk Summary

Studies have indicated that phenytoin can negatively impact cognitive function, including visual motor speed, memory, attention, focus, and processing speed. 1 , 3 , 6 , 7 While phenytoin may not significantly impact psychomotor performance in children with well-controlled seizures and low therapeutic doses, 5 higher doses or fluctuations in drug levels could potentially lead to cognitive impairment. 6 Additionally, phenytoin can affect liver function. 2

Comparison of Studies

Commonalities

Multiple studies suggest that phenytoin may have negative effects on cognitive function. 1 , 3 , 6 , 7 Another consistent finding across studies is that phenytoin, like carbamazepine, may negatively affect motor skills, speed, and memory. 3 ,

Differences

The specific effects of phenytoin on cognitive function can vary across studies. 1 , 3 , 6 , 7 For instance, while some studies show negative impacts on visual motor speed, 3 , 6 others report that phenytoin does not significantly affect motor skills when administered in low therapeutic doses. 5

Consistency and Contradictions in Results

Multiple studies have shown potential negative effects of phenytoin on cognitive function; however, the extent and specific nature of these effects can vary. 1 , 3 , 6 , 7 While research suggests that phenytoin may not impact cognitive function significantly when blood levels are within the therapeutic range, 7 higher doses or fluctuations in blood levels can negatively impact cognitive function. 6

Application in Everyday Life

Phenytoin is a valuable medication for preventing and treating epileptic seizures, but it may impact cognitive function. 1 , 3 , 6 , 7 Therefore, it is crucial to consider these potential effects when using phenytoin. 1 Regular monitoring of blood levels is recommended to adjust dosage as needed. 6 It is important to undergo regular liver function tests due to phenytoin's potential to affect liver health. 2 Always follow your doctor's instructions and schedule regular checkups when using phenytoin.

Limitations of Current Research

Research on phenytoin's impact on cognitive function remains insufficient. 1 , 3 , 6 , 7 More research, especially on the long-term effects, is needed. 3 , The variability in individual responses to phenytoin makes it essential to conduct further studies to gain a comprehensive understanding of its cognitive effects. 6

Future Research Directions

Further research is needed to better understand the impact of phenytoin on cognitive function. 1 , 3 , 6 , 7 Long-term studies are crucial to determine the long-term effects of phenytoin on cognitive function. 3 , Additional research is needed to understand individual variability in responses to phenytoin and to develop more personalized treatment plans. 6

Conclusion

Phenytoin is a valuable medication for preventing and treating epileptic seizures, but it can potentially impact cognitive function. 1 , 3 , 6 , 7 It is essential to be aware of these potential effects and to consider them when using phenytoin. 1 Regular monitoring of blood levels is necessary to adjust dosage as needed. 6 Liver function tests should be done regularly as phenytoin can affect liver health. 2 Always follow your doctor's instructions and schedule regular checkups when using phenytoin.

Literature analysis of 11 papers
Positive Content
7
Neutral Content
2
Negative Content
2
Article Type
11
0
0
0
11
1.

Neurobehavioral effects of phenytoin prophylaxis of posttraumatic seizures.

Author: DikmenS S, TemkinN R, MillerB, MachamerJ, WinnH R

Control seizures
Cognitive impairment

Phenytoin had negative cognitive effects in severely injured patients, raising concerns about its long-term use for preventing posttraumatic seizures.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

2.

Comparison of valproic acid and phenytoin in newly diagnosed tonic-clonic seizures.

Author: WilderB J, RamsayR E, MurphyJ V, KarasB J, MarquardtK, HammondE J

Mild side effects
Seizure prevention
Toxic hepatitis

Valproate and phenytoin were both effective in preventing seizure recurrence in newly diagnosed epileptic patients. Valproate was more effective than phenytoin, with similar mild side effects and laboratory abnormalities.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.

Language : English

3.

Comparing the cognitive effects of phenytoin and carbamazepine in long-term monotherapy: a two-year follow-up.

Author: PulliainenV, JokelainenM

Few cognitive effects
Improved mood
Negative effects on motor speed
Negative effects on visual memory

This study compared the cognitive effects of phenytoin (PHT) and carbamazepine (CBZ) in newly diagnosed epilepsy patients. While both drugs showed similar effects on mood, PHT exhibited negative effects on visually guided motor speed and visual memory. The findings suggest that long-term cognitive effects of PHT, compared to CBZ, may be limited to certain visual-motor functions.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

4.

Neurobehavioral effects of phenytoin and carbamazepine in patients recovering from brain trauma: a comparative study.

Author: SmithK R, GouldingP M, WildermanD, GoldfaderP R, Holterman-HommesP, WeiF

Cognitive impairment
Motor speed impairment

The study found that both phenytoin and carbamazepine may have negative effects on cognitive performance, particularly on tasks involving motor and speed components. While practice effects may account for some improvement when patients stopped taking these drugs, the overall effects were small and of limited clinical significance.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Effects of phenytoin on cognitive-motor performance in children as a function of drug concentration, seizure type, and time of medication.

Author: AmanM G, WerryJ S, PaxtonJ W, TurbottS H

Improved psychomotor performance

This study found that fluctuations in phenytoin (PHT) levels, of the order of 50%, had no discernible effects on psychomotor performance in children with well-controlled seizures receiving PHT monotherapy.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Effects of phenytoin and carbamazepine on cognitive functions in newly diagnosed epileptic patients.

Author: PulliainenV, JokelainenM

Improved mood
Cognitive impairment

Both phenytoin and carbamazepine decreased the normal practice effect observed in neuropsychological testing, with phenytoin showing a greater effect. Phenytoin also led to slower reaction times and decreased visual memory, particularly in women and patients with higher serum levels.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

7.

Computerized task battery assessment of cognitive and performance effects of acute phenytoin motion sickness therapy.

Author: ChelenW, AhmedN, KabriskyM, RogersS

Motion sickness treatment

Phenytoin is a drug that is used to treat seizures. This study found that phenytoin, when used at levels that are effective for treating motion sickness, did not have any significant negative effects on cognitive function or performance.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

8.

Comparison of phenobarbitone, phenytoin with sodium valproate: randomized, double-blind study.

Author: ThilothammalN, BanuK, RatnamR S

Effective seizure control
Minimal side effects
Hyperactivity
Side effects

Phenobarbitone, phenytoin, and sodium valproate were equally effective in controlling generalized tonic-clonic convulsions. However, sodium valproate had the fewest side effects, followed by phenobarbitone.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Side effects and mortality associated with use of phenytoin for early posttraumatic seizure prophylaxis.

Author: HaltinerA M, NewellD W, TemkinN R, DikmenS S, WinnH R

Seizure prevention
Adverse effects

The use of phenytoin to prevent early posttraumatic seizures following head injury was evaluated for its association with significant adverse side effects and its effect on mortality rates in head-injured patients.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

10.

Effects of oxcarbazepine and phenytoin on the EEG and cognition in healthy volunteers.

Author: SalinskyM C, SpencerD C, OkenB S, StorzbachD

Improved vigor
Cognitive effects
EEG slowing

This study compared the effects of oxcarbazepine and phenytoin on brain activity and cognitive function in healthy volunteers. Both drugs had significant effects on brain activity, but only minor effects on cognitive function.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

Topiramate effects on the EEG and alertness in healthy volunteers: a different profile of antiepileptic drug neurotoxicity.

Author: SalinskyMartin, StorzbachDaniel, OkenBarry, SpencerDavid

topiramate EEG effects

This study investigated the effects of topiramate (TPM) on quantitative EEG (QEEG) and drowsiness. The hypothesis was that TPM would induce significant slowing of EEG background rhythms and an increase in drowsiness on the awake maintenance task (AMT).

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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