Biomedical subjects

K R Perrine

Publications and source records attributed to K R Perrine.

3 recordsLinked to original sources

PubMed2001

Differential cognitive and behavioral effects of carbamazepine and lamotrigine.

BACKGROUND: The relative cognitive and behavioral effects of lamotrigine compared with the older standard antiepileptic drugs (AED) are uncertain. OBJECTIVE: To directly compare the cognitive and behavioral effects of carbamazepine and lamotrigine. METHODS: The cognitive and behavioral effects of carbamazepine and lamotrigine were assessed in 25 healthy adults using a double-blind, randomized crossover design with two 10-week treatment periods. During each treatment condition, subjects received either lamotrigine (150 mg/day) or carbamazepine (mean 696 mg/day) adjusted to a dose to achieve midrange standard therapeutic blood levels (mean 7.6 microg/mL). Subjects were tested at the end of each AED treatment period and in three drug-free conditions (two pretreatment baselines and a final posttreatment period [1 month after last AED]). The neuropsychological test battery included 19 measures yielding 40 total variables. RESULTS: Direct comparison of the two AED revealed significantly better performance on 19 (48%) variables for lamotrigine but none for carbamazepine. Differences spanned both objective cognitive and subjective behavioral measures, including cognitive speed, memory, graphomotor coding, neurotoxic symptoms, mood factors, sedation, perception of cognitive performance, and other quality-of-life perceptions. Comparison of carbamazepine with the nondrug average revealed significantly better performance for nondrug average on 24 (62%) variables but none for carbamazepine. Comparison of lamotrigine with nondrug average revealed better performance on one (2.5%) variable for nondrug average and on one (2.5%) variable for lamotrigine. CONCLUSION: Lamotrigine produces significantly fewer untoward cognitive and behavioral effects than carbamazepine at the dosages used in this study.

Adult↗

PubMed1993

A new quality-of-life inventory for epilepsy patients: interim results.

The process for developing and evaluating a comprehensive, self-report measure of quality of life in epilepsy (QOLIE) is described, and interim results for 64 patients are reported. A test battery of 98 quality-of-life items was constructed with use of the RAND 36-Item Health Survey as a generic core and adding other quality-of-life items, the latter derived from a literature review and expert opinion on areas of importance to people with mild to moderate epilepsy. Seventeen scales tapping unique quality-of-life dimensions were identified from this QOLIE test battery. The battery was administered to 64 adults with mild to moderate epilepsy and their proxies (relative or close friend) on two separate visits 2-3 weeks apart. Patients also completed a neuropsychological test battery on the first visit. Interim analysis of these data demonstrated that 16 of 17 scales on the QOLIE test battery are sufficiently reliable for group comparison: Cronbach's alpha for the 16 scales ranged from 0.73 to 0.88; test-retest reliability ranged from 0.56 to 0.88. Preliminary evaluation of validity confirmed hypothesized correlations between selected QOLIE scales and Profile of Mood State scales. Correlations between patient and proxy scores ranged from 0.29 to 0.69 (all statistically significant at p < 0.005). A more detailed, final analysis of data for over 300 patients currently enrolled in the study will be published later.

Adaptation, Psychological↗

PubMed1991

Psychopathology in epilepsy.

Although the majority of epileptics who are well controlled on medication do not show significant evidence of psychopathology, a subset of epileptics have serious psychiatric disturbances. Risk factors for the development of psychopathology appear to include poorly-controlled seizures, a long duration of seizure disorder with onset in childhood, seizure focus in the temporal lobe, bilateral or multiple discharges on EEG, and structural lesions. All of these factors appear to put the patient at greater risk of brain dysfunction, possibly because of the disruption of limbic functions associated with behavior and personality. The onset of seizures in childhood is likely to affect the development of personality and social functioning adversely. Although not a focus of this article, premorbid personality, psychologic reactions to having epilepsy, and the social problems accompanying the disease are likely to contribute greatly to the development of psychopathology. The development of psychiatric disorders in epilepsy thus appears to be a complex, multifactorial process. No single factor, such as seizure type, EEG findings, lateralization, pathology, or demographic variables is likely to be explanatory. Recent research has focused on accounting for many of these factors, and future investigations should shed further light on why some epileptics develop psychiatric problems and how best to treat these disorders.

Dissociative Disorders↗