Anti-epileptic drugs: behavior and cognition

Anti-epileptic drugs (AEDs) are characterized by a variety of mechanisms of action, leading to different anticonvulsant activities and behavioral/psychotropic profiles. At the one end of the pharmacodynamic spectrum are AEDs potentiating inhibitory gammaaminobutyric acid (GABA) neurotransmission. The other end of the spectrum comprises AEDs attenuating excitatory glutamate neurotransmission. GABA-enhancing AEDs have sedating and anti-manic effects, while the second group is characterized by antidepressant effects. This chapter reviews the mechanisms of action, main clinical indications, and behavioral and cognitive profiles of a range of AEDs. In clinical practice, both patients' characteristics and AEDs' cognitive and behavioral profiles should be taken into account in order to maximize benefits in terms of seizure control and behavioral and cognitive outcome.