Distinct cognitive neurophysiologic profiles for lamotrigine and topiramate

Michael E. Smith, Alan Gevins, Linda K. McEvoy, Kimford J. Meador, Patricia G. Ray, Frank Gilliam

Research output: Contribution to journalArticlepeer-review

63 Scopus citations


Purpose: To contrast the effects of lamotrigine (LTG) and topiramate (TPM) on cognitive task-related and resting-state EEG and evoked potential (EP) measures. Methods: We used a double-blind, randomized, crossover design. Healthy adults (N = 29) had two 8-week periods of dose escalation, 4 weeks of drug maintenance (300 mg daily), and 4 weeks of washout. EEG was recorded during working memory (WM) tasks and resting conditions at baseline, at the end of each maintenance phase, and after final washout. Results: LTG did not affect overt performance on the tasks, although it reduced EEG power in both resting and WM task conditions, most prominently in the 6- to 12-Hz frequency range, and attenuated P300 evoked-potential amplitude equally in both WM task loads. TPM slowed responses and increased errors. It also increased EEG power below 6 Hz in all conditions, and reduced the amplitude of a slow wave observed in a difficult version of the WM task. Conclusions: The drugs produced both task-independent and task-related alterations in neurophysiologic measures. The EEG and EP changes produced by TPM are consistent with an impairment of WM, as evidenced by overt performance deficits on the behavioral tasks. By contrast, the reduction in synchronous cortical activity produced by LTG was not accompanied by cognitive impairment. It is unknown whether such effects would also be observed at lower doses, such as those that often are used in monotherapy for newly diagnosed patients.

Original languageEnglish (US)
Pages (from-to)695-703
Number of pages9
Issue number4
StatePublished - Apr 2006
Externally publishedYes


  • Antiepileptic drugs
  • Cognition
  • EEG
  • Epilepsy
  • Evoked potentials
  • Lamotrigine
  • Neurophysiology
  • Topiramate
  • Working memory

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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