TY - JOUR
T1 - Subjective preference for lamotrigine or topiramate in healthy volunteers
T2 - Relationship to cognitive and behavioral functioning
AU - Werz, Mary Ann
AU - Schoenberg, Mike R.
AU - Meador, Kimford J.
AU - Loring, David W.
AU - Ray, Patty G.
AU - Kaul-Gupta, Rina
AU - Ogrocki, Paula
N1 - Funding Information:
This study was supported by a grant from GlaxoSmithKline. Results were presented in part at the 2004 American Epilepsy Society Meeting in New Orleans, Louisiana.
PY - 2006/2
Y1 - 2006/2
N2 - Objective. Outcomes research emphasizes patient self-assessment and preferences in optimizing treatment. We previously showed that lamotrigine produces significantly less cognitive and behavioral impairment compared with topiramate. In the current study we extend these observations to subject self-report of preference for lamotrigine or topiramate independent of potentially confounding effects of seizures or seizure control. Additionally, drug preference was related to effects of lamotrigine and topiramate on objective neuropsychological tests as well as self-perception on behavioral instruments. Methods: Thirtyseven healthy volunteers completed a double-blind, randomized crossover design incorporating tow 12-week treatment periods of lamotrigine and topiramate each titrated to a dose of 300 mg/day. Evaluation of 23 objective neuropsychological and 15 subjective behavioral measures occurred at four times: pretreatment baseline, first treatment, second treatment, and posttreatment baseline. Preference for lamotrigine or topiramate was assessed, while blinding was maintained, at the final study visit when each subject was asked which drug he or she would prefer to take. Results: A large majority (70%) preferred lamotrigine, 16% stated preference for topiramate, and 14% had no preference (drugs equivalent). Consistennt with preference, those preferring lamotrigine performed better on 19 of 23 objective and 13 of 15 subjective behavioral measurement while on lamotrigine. Inconsistent with preference, subjects preferring topiramate performed better on 19 of 23 objective and 9 of 15 subjective behavioral measures while on lamotrigine. Topiramate preference also did not correlate with IQ, serum concentration, body mass index, age, or gender. Topiramate preference did relateto responses on the Profile of Mood States. Conclusion: Lamotrigine was preferred by the majority of subjects, congruent with objective neuropsychological and subjective behavioral measures. In contrast, for those stating a preference for topiramate the results on objective neuropsychological measures were impaired while fewer complaints were noted on the Profile of Mood States. This suggests that preference for topiramate may be determined by an effect on mood.
AB - Objective. Outcomes research emphasizes patient self-assessment and preferences in optimizing treatment. We previously showed that lamotrigine produces significantly less cognitive and behavioral impairment compared with topiramate. In the current study we extend these observations to subject self-report of preference for lamotrigine or topiramate independent of potentially confounding effects of seizures or seizure control. Additionally, drug preference was related to effects of lamotrigine and topiramate on objective neuropsychological tests as well as self-perception on behavioral instruments. Methods: Thirtyseven healthy volunteers completed a double-blind, randomized crossover design incorporating tow 12-week treatment periods of lamotrigine and topiramate each titrated to a dose of 300 mg/day. Evaluation of 23 objective neuropsychological and 15 subjective behavioral measures occurred at four times: pretreatment baseline, first treatment, second treatment, and posttreatment baseline. Preference for lamotrigine or topiramate was assessed, while blinding was maintained, at the final study visit when each subject was asked which drug he or she would prefer to take. Results: A large majority (70%) preferred lamotrigine, 16% stated preference for topiramate, and 14% had no preference (drugs equivalent). Consistennt with preference, those preferring lamotrigine performed better on 19 of 23 objective and 13 of 15 subjective behavioral measurement while on lamotrigine. Inconsistent with preference, subjects preferring topiramate performed better on 19 of 23 objective and 9 of 15 subjective behavioral measures while on lamotrigine. Topiramate preference also did not correlate with IQ, serum concentration, body mass index, age, or gender. Topiramate preference did relateto responses on the Profile of Mood States. Conclusion: Lamotrigine was preferred by the majority of subjects, congruent with objective neuropsychological and subjective behavioral measures. In contrast, for those stating a preference for topiramate the results on objective neuropsychological measures were impaired while fewer complaints were noted on the Profile of Mood States. This suggests that preference for topiramate may be determined by an effect on mood.
KW - Cognition
KW - Drug preference
KW - Epilepsy health outcome
KW - Lamotrigine
KW - Mood
KW - Topiramate
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U2 - 10.1016/j.yebeh.2005.09.003
DO - 10.1016/j.yebeh.2005.09.003
M3 - Article
C2 - 16377253
AN - SCOPUS:30844450089
SN - 1525-5050
VL - 8
SP - 181
EP - 191
JO - Epilepsy and Behavior
JF - Epilepsy and Behavior
IS - 1
ER -