Effects of phenelzine: A Synthesis of Findings from 11 Studies

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Original Abstract of the Article

Major findings

Several studies have investigated the effects of various antiepileptic drugs (AEDs) on brain activity and cognitive function. These studies have shown that AEDs can have significant effects on the brain, including slowing down brain waves and causing drowsiness. 11 Specifically, topiramate (TPM) has been shown to induce significant slowing of EEG background rhythms and increase drowsiness on the awake maintenance task (AMT). 11 This is consistent with previous studies that have found similar effects with other AEDs such as carbamazepine (CBZ), oxcarbazepine (OXC), and phenytoin (PHT). 11 Additionally, 10 has demonstrated that both OXC and PHT slow down EEG peak frequency and increase relative theta and delta power, suggesting that these AEDs may have similar effects on brain activity.

Other studies have focused on the cognitive effects of AEDs. For instance, 4 found that both phenytoin and carbamazepine had negative effects on cognitive performance in patients recovering from brain trauma, particularly on tasks requiring motor speed and accuracy. Interestingly, 1 showed that phenytoin significantly impaired performance in severely injured patients at one month post-injury. On the other hand, 5 observed that phenytoin had minimal effects on cognitive-motor performance in children with well-controlled seizures who were receiving low therapeutic dosages.

Some studies have also compared the efficacy and side effects of different AEDs. For example, 2 compared valproic acid (VPA) and phenytoin in newly diagnosed epileptic patients and found that both drugs were effective in preventing seizures, but VPA had fewer side effects. 8 compared phenobarbitone, phenytoin, and sodium valproate and found that all three drugs were equally effective in controlling seizures, but sodium valproate had the fewest side effects.

Benefits and Risks

Benefits summary

Several AEDs have been found to be effective in preventing or controlling seizures, including phenytoin, valproic acid, and phenobarbitone. 2 8 Phenytoin has also been shown to be effective in treating motion sickness. 7

Risks summary

AEDs can cause a range of side effects, including drowsiness, cognitive impairment, and mood changes. 11 10 4 Phenytoin, in particular, has been associated with negative cognitive effects, especially in individuals with severe brain injuries. 1 Valproic acid may have fewer cognitive effects than phenytoin, but it can still cause side effects. 2 Topiramate has been shown to have significant negative effects on cognitive function. 11 It's crucial to discuss any potential side effects with your doctor, as they can vary depending on the individual and the specific AED being used.

Comparison between studies

Commonalities between studies

Several studies have consistently found that AEDs can have negative effects on brain activity, particularly slowing down brain waves and causing drowsiness. 11 10 Additionally, many studies have shown that AEDs can impair cognitive function, including attention, memory, and motor skills. 4 1 3

Differences between studies

While several studies have demonstrated the negative effects of AEDs, the extent of these effects varies depending on the specific AED, the dosage, the patient's individual characteristics, and the type of cognitive tasks assessed. For example, 5 found that phenytoin had minimal effects on cognitive-motor performance in children with well-controlled seizures who were receiving low therapeutic dosages, suggesting that the dosage and control of seizures might play a crucial role in the impact of the AED. Additionally, 8 showed that sodium valproate had the fewest side effects compared to phenobarbitone and phenytoin, highlighting the potential differences in side effects between various AEDs.

Consistency and contradictions of findings

While many studies have found that AEDs can have negative effects on brain activity and cognitive function, the consistency of these findings varies. For example, while several studies have found that phenytoin can impair cognitive function, 5 found minimal effects in children with well-controlled seizures who were receiving low therapeutic dosages. This discrepancy highlights the need for further research to understand the complex interplay between AEDs, dosage, individual characteristics, and cognitive function. Furthermore, the specific mechanisms by which AEDs affect brain activity and cognitive function remain to be fully elucidated.

Implications for real-life application

The findings of these studies highlight the importance of careful monitoring and management of AED therapy. Individuals taking AEDs should be aware of the potential side effects and discuss any concerns with their doctor. It's crucial to follow the prescribed dosage and schedule and be attentive to any changes in cognitive function or behavior. Additionally, engaging in activities that require alertness, such as driving or operating machinery, should be done with caution and under the guidance of a healthcare professional.

Limitations of current research

Many of these studies have limitations, including small sample sizes, short follow-up periods, and a lack of detailed information on patient characteristics. Further research is necessary to address these limitations and gain a more comprehensive understanding of the effects of AEDs on brain activity and cognitive function.

Future research directions

Future research should focus on the long-term effects of AEDs on brain activity and cognitive function. Additionally, research is needed to identify biomarkers and early indicators of potential cognitive decline associated with AED use. Furthermore, research should investigate the potential for individualized AED therapy, considering the unique characteristics and needs of each patient.

Conclusion

AEDs can have significant effects on brain activity and cognitive function, with potential for both benefits and risks. While they can effectively control seizures, they can also cause drowsiness, cognitive impairment, and mood changes. Understanding the complex interplay between AEDs, dosage, individual characteristics, and cognitive function is crucial for optimizing therapy and minimizing potential adverse effects. Further research is necessary to identify the specific mechanisms by which AEDs affect brain activity and cognitive function and to develop strategies for personalized therapy that maximizes benefits and minimizes risks.

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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