Effects of phenytoin injection: A Synthesis of Findings from 11 Studies

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Original Abstract of the Article

Major Research Findings

Multiple studies have shown that phenytoin, a medication commonly used for seizure prevention after brain trauma, can have negative effects on cognitive function. 4 , 1 , 6 For example, patients taking phenytoin have been found to perform worse on tasks involving motor speed and visual memory compared to those taking a placebo. 1 Phenytoin has also been linked to side effects like slowed brainwave activity and drowsiness. 11 While carbamazepine may have less of an impact on cognition than phenytoin, 6 , some research suggests it can also cause side effects like reduced visually-guided motor speed. Oxcarbazepine might have a smaller effect on cognition compared to phenytoin and carbamazepine, 10 , but it can also cause brainwave slowing similar to phenytoin. 10 All these medications can lead to side effects like mood changes and fatigue. 6 , 10

Benefits and Risks

Benefits Summary

Antiepileptic drugs like phenytoin and carbamazepine have been shown to be effective in preventing seizures after brain trauma. 4 , 2 These medications have the potential to improve the quality of life for patients who have experienced brain trauma by preventing seizures.

Risks Summary

Antiepileptic drugs like phenytoin and carbamazepine can have negative effects on cognitive function, potentially leading to poorer performance on tasks involving motor speed and visual memory. 4 , 1 , 6 , They can also cause side effects like slowed brainwave activity and drowsiness. 11 , 10 All these medications can lead to side effects like mood changes and fatigue. 6 , 10

Comparison Between Studies

Similarities

Multiple studies have shown that antiepileptic drugs like phenytoin and carbamazepine can have negative effects on cognitive function. 4 , 1 , 6 , These medications can also lead to side effects like mood changes and fatigue. 6 , 10

Differences

Comparing results across these studies can be challenging because of differences in the medications used, dosages administered, and evaluation methods. For instance, phenytoin might have a greater impact on motor speed and visual memory compared to carbamazepine. 6 , Oxcarbazepine may have less of an effect on cognition compared to phenytoin and carbamazepine. 10 However, these studies often have small sample sizes, necessitating further research.

Consistency and Contradictions

While multiple studies point to the potential negative effects of antiepileptic drugs like phenytoin and carbamazepine on cognitive function, 4 , 1 , 6 , the precise extent of these effects and the specific patients who are most susceptible remain unclear. These medications can also cause side effects like mood changes and fatigue. 6 , 10 The severity of these side effects can vary significantly between individuals.

Practical Applications and Considerations

When using antiepileptic drugs like phenytoin and carbamazepine to prevent seizures after brain trauma, it is essential to consider the potential impact on cognitive function and the risk of side effects. 4 , 1 , 6 , These medications can also lead to side effects like mood changes and fatigue. 6 , 10 The severity of these side effects can vary significantly between individuals. Consultation with a physician is vital to explore the most suitable treatment options for each patient.

Limitations of Current Research

The available studies often have small sample sizes, requiring further investigation. Additionally, comparing results across different studies can be challenging due to variations in the medications used, dosages, and evaluation methods.

Future Research Directions

More research is needed to understand the extent to which antiepileptic drugs like phenytoin and carbamazepine affect cognitive function and the specific patient characteristics that might influence these effects. 4 , 1 , 6 , Further research is also required to develop methods for mitigating the side effects of these medications. 11 , 10

Conclusion

While antiepileptic drugs like phenytoin and carbamazepine can be effective in preventing seizures after brain trauma, 4 , 2 they come with the potential for negative effects on cognitive function and side effects. 4 , 1 , 6 , When considering these medications for seizure prevention after brain trauma, it's crucial to weigh the potential benefits against these risks. Consulting with a doctor to determine the most appropriate treatment plan for each individual is essential.

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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