Neurobehavioral Effects of Anticonvulsants
- David W. Loring, PhD;
- Kimford J. Meador, MD
Since this article does not have an abstract, we have provided the first 150 words of the full text.
Excerpt
To the Editor. —We cannot agree with the JAMA editorial by Trimble1 that phenytoin produces greater impairment of cognitive functions than either carbamazepine or valproate sodium. The studies cited by Trimble have both methodological and statistical shortcomings that limit the confidence with which conclusions can be drawn, and his literature review selectively omits contradictory results.
Thompson et al2,3 examined the effects of phenytoin and valproate on healthy subjects in separate studies and concluded that phenytoin produces greater functional impairment. However, results from these reports cannot be compared directly since they were not derived using identical approaches to data analysis (ie, treatment minus baseline difference scores for phenytoin2 and drug vs placebo contrasts for valproate3).
To directly compare results from these studies, we calculated the Student t tests from their data. Comparing phenytoin with valproate treatment, we observed significant differences for both color (P<.01) and category
