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The aims of this study were to explore further whether cognitive changes in Moban (Molindone Hydrochloride Tablets)- FDA patients were indeed a consequence of topiramate and to assess whether certain cognitive processes, in particular measures involving verbal processing, were selectively affected.

The patients studied had intractable epilepsy and were attending a tertiary referral epilepsy assessment unit. Eighteen consecutive referrals taking topiramate at the time of the assessment were included if a neuropsychological assessment had been undertaken before the introduction of this Moban (Molindone Hydrochloride Tablets)- FDA. All patients were receiving at least one other antiepileptic drug.

Topiramate dosage ranged from Moban (Molindone Hydrochloride Tablets)- FDA mg to 600 mg with a median of 300 mg. For five Moban (Molindone Hydrochloride Tablets)- FDA complaints of cognitive deterioration were a major factor precipitating a further assessment. Of the remaining 13 patients, seven had been referred for presurgical investigations and six because of suboptimal Moban (Molindone Hydrochloride Tablets)- FDA control or the need for diagnositic clarification.

A subgroup of eight patients was Moban (Molindone Hydrochloride Tablets)- FDA for a brief reassessment a minimum of 10 days after the discontinuation or a substantial reduction of the drug. The topiramate dose of these patients ranged from 175 mg to 600 mg. At the reassessment seven patients were no longer on the drug and one patient had the dosage reduced from 600 mg to 175 mg. Patients Moban (Molindone Hydrochloride Tablets)- FDA recruited from the same source if two neuropsychological assessments had been undertaken at about the same time interval as in group 1.

Patients who had known neurodegenerative conditions were excluded. No recent drug changes had taken place in either group. Tables 1 and 2 glucophage metformin demographic, seizure, and treatment related details. The neuropsychological tests were not selected to be sensitive to drug effects. The measures formed part of the routine neuropsychological assessment of our Moban (Molindone Hydrochloride Tablets)- FDA service.

There was some variability in the tests given to individual patients and therefore we selected only those measures that had been administered in both assessments. These are described briefly below. Verbal subtests were analysed as a quotient and also as individual subtests to enable more detailed analysis of verbal processing. The performance subtests were analyzed only as the overall prorated quotient. The story recall and list learning subtests from the adult memory and Moban (Molindone Hydrochloride Tablets)- FDA processing battery (AMIPB) were administered.

In the list learning task the patient is read a list of 15 common words and asked to recall as many as possible. The list is then Moban (Molindone Hydrochloride Tablets)- FDA a further four times with the patient recalling as many words as possible after each trial.

Then a second list of 15 words is presented. The patient is required to recall as many as possible from the second list (list B) and then from the original list without a further presentation (list A 6).

The subject is required to name 30 line drawings of objects of increasing difficulty. The score derived is the total number correct. The two totals achieved were analysed individually. The de Renzi token test (shortened version ) provided a measure of verbal comprehension. The subject is required to manoeuvre coloured shapes by command. There are 15 commands of increasing verbal complexity.

The score is the total number correct. In the first the subject is required to copy a complex figure and produce a version from memory, both immediately and then after a 30 minute delay. In the learning paradigm the subject is shown a simple geometric design for 10 seconds. The stimulus is removed and the subject is required to produce a copy.

The subject must identify each letter from the incomplete stimulus. The score is the total number of letters correctly identified. A record was made for complex partial seizures, generalised tonic-clonic seizures, and atonic seizures. Estimates were not always available for myoclonic jerks and simple partial seizures and for this reason no figures are provided.

The type of medication and dosage at the time of each testing session were recorded (table 2). For all test measures a higher score indicated better performance. Change scores were evaluated for each test and subtest by subtracting the first test score from the second, a positive score representing an improvement and a negative score a deterioration.

Independent samplet tests were used to assess for group differences Moban (Molindone Hydrochloride Tablets)- FDA change Moban (Molindone Hydrochloride Tablets)- FDA scores. Paired sample t tests were performed on the test-retest scores of the eight period no cramps in the withdrawal group.

Further correlational analyses were undertaken to explore whether there was any relation between topiramate dosage and the degree of change on the cognitive tests. Wilcoxon t tests were employed to assess whether significant changes in seizure frequency occurred between the sessions for the two patient groups.

No patient experienced a deterioration in seizure control when treated with topiramate. For generalised tonic-clonic seizures the change in frequency ranged from no change in one patient, to no attacks during the 3 month period in six cases. There were no statistically significant changes in seizure frequency in the comparison group. The groups varied in the drugs taken on the two testing sessions (table 2).

The topiramate group were by definition all taking the drug in the second session. At this second session four were no longer taking gabapentin and four were no longer taking lamotrogine.



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