TY - JOUR

T1 - Pharmacological Medical Treatment of Epilepsy in Patients with Dementia

T2 - A Systematic Review

AU - Musaeus, Christian S.

AU - Nilsson, Christer

AU - Cooper, Chris

AU - Kramberger, Milica G.

AU - Verdelho, Ana

AU - Stefanova, Elka

AU - Religa, Dorota

AU - Waldemar, Gunhild

AU - Frederiksen, Kristian S.

N1 - Publisher Copyright: © 2021 Bentham Science Publishers.

PY - 2021

Y1 - 2021

N2 - Background: Patients with dementia have an increased risk of developing epilepsy, es-pecially in patients with vascular dementia and Alzheimer’s disease. In selecting the optimal an-ti-epileptic drug (AED), the possible side effects such as drowsiness and worsening of cognitive function should be taken into consideration, together with co-morbidities and type of epilepsy. Objective: The current systematic review investigates the efficacy, tolerability, and changes in cognitive function after administration of AED in patients with dementia and epilepsy. Methods: We searched six databases, including MEDLINE and CENTRAL, checked reference lists, contacted experts, and searched Google Scholar to identify studies reporting randomized trials. Studies identified were independently screened, data extracted, and quality appraised by two researchers. A narrative synthesis was used to report findings. Results: We included one study with 95 patients with Alzheimer’s disease randomized to either lev-etiracetam, lamotrigine, or phenobarbital. No significant differences were found for efficacy, but patients receiving levetiracetam showed an improvement in mini-mental state examination scores and had fewer adverse events. Conclusion: High-quality evidence in the form of randomized controlled trials to guide clinicians in choosing an AED in patients with dementia and concomitant epilepsy remains scarce. However, levetiracetam has previously been shown to possibly improve cognition in patients with both mild cognitive impairment and Alzheimer’s disease, is better tolerated in the elderly population, and has no clinically relevant interaction with either cholinesterase inhibitors or NMDA receptor antagon-ists. Registration No: The protocol was registered in the PROSPERO database (ID: CRD42020176252).

AB - Background: Patients with dementia have an increased risk of developing epilepsy, es-pecially in patients with vascular dementia and Alzheimer’s disease. In selecting the optimal an-ti-epileptic drug (AED), the possible side effects such as drowsiness and worsening of cognitive function should be taken into consideration, together with co-morbidities and type of epilepsy. Objective: The current systematic review investigates the efficacy, tolerability, and changes in cognitive function after administration of AED in patients with dementia and epilepsy. Methods: We searched six databases, including MEDLINE and CENTRAL, checked reference lists, contacted experts, and searched Google Scholar to identify studies reporting randomized trials. Studies identified were independently screened, data extracted, and quality appraised by two researchers. A narrative synthesis was used to report findings. Results: We included one study with 95 patients with Alzheimer’s disease randomized to either lev-etiracetam, lamotrigine, or phenobarbital. No significant differences were found for efficacy, but patients receiving levetiracetam showed an improvement in mini-mental state examination scores and had fewer adverse events. Conclusion: High-quality evidence in the form of randomized controlled trials to guide clinicians in choosing an AED in patients with dementia and concomitant epilepsy remains scarce. However, levetiracetam has previously been shown to possibly improve cognition in patients with both mild cognitive impairment and Alzheimer’s disease, is better tolerated in the elderly population, and has no clinically relevant interaction with either cholinesterase inhibitors or NMDA receptor antagon-ists. Registration No: The protocol was registered in the PROSPERO database (ID: CRD42020176252).

KW - Alzheimer’s disease

KW - Anti-epileptic medication

KW - Dementia

KW - Epilepsy

KW - Levetiracetam

KW - Older adults

U2 - 10.2174/1567205018666211126121529

DO - 10.2174/1567205018666211126121529

M3 - Review

C2 - 34825872

AN - SCOPUS:85123389218

VL - 18

SP - 689

EP - 694

JO - Current Alzheimer Research

JF - Current Alzheimer Research

SN - 1567-2050

IS - 9

ER -