Editors' note: Antiepileptic drugs are not independently associated with cognitive dysfunction

In “Antiepileptic drugs (AEDs) are not independently associated with cognitive dysfunction,” Foster et al. studied cognitive function in 331 patients admitted to an inpatient epilepsy unit and found that although age, seizure frequency, depression, anxiety, and diagnosis of both epilepsy and psychogenic nonepileptic seizures were related to cognitive dysfunction identified by the Neuropsychiatry Unit Cognitive Assessment Tool and the Quality of Life in Epilepsy inventory, individual antiepileptic drugs (AEDs) were not. Witt et al. commented that these results erroneously—and, perhaps, dangerously—suggest AEDs do not impact cognitive function because the tests used did not assess for specific cognitive deficits, which are known to be associated with both AED selection and dosing. Foster agreed that other tests may be more sensitive to these subdomains of cognitive dysfunction and acknowledged that some patients may be more likely to experience cognitive changes related to AEDs, but reiterated that the intent of the study was to assess global cognitive function and that their findings demonstrate factors other than AEDs are associated with cognitive impairment in patients with epilepsy. They also noted that clinicians must, of course, thoughtfully apply these findings to clinical practice and recognize that these results do not preclude the potential for AEDs to impact attention and executive function.