What topics does this cannabis study cover?

This study covers research on: CBD, Epilepsy.

Where was this research published?

Published in CNS drugs on September 9, 2026.

Review finds newer antiseizure drugs generally spare cognition

Cognitive Side Effects of Antiseizure Medications in Adults with Epilepsy: An Update with a Focus on New Therapeutic Agents.

CNS drugs • September 9, 2026 • Review • Moderately Relevant

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AI Summary

This narrative review asked how antiseizure medications affect cognition in adults with epilepsy, with particular attention to newer drugs introduced since 2009. The authors searched PubMed for research published through December 2025, drawing on randomised trials, observational studies, meta-analyses, and systematic reviews. The main outcomes were effects on attention, processing speed, memory, language, and executive function. The abstract reports no single quantitative estimate of cognitive risk, reflecting the varied evidence across medications, doses, treatment combinations, and individual patients.

Overall, newer antiseizure medications—including cannabidiol (CBD), lacosamide, brivaracetam, and others—showed generally favourable cognitive profiles at recommended doses, especially when used alone or in carefully selected combinations. Eslicarbazepine and cenobamate may produce mild, dose-related cognitive effects at the upper end of their recommended ranges, while topiramate and zonisamide remain more consistently associated with cognitive problems. Older adults and people with intellectual disabilities may be especially vulnerable. Because this is a narrative review rather than a new clinical trial, the abstract-based summary cannot establish that one medication is universally superior or fully separate medication effects from epilepsy-related cognitive impairment; no quantitative results are provided in the abstract.

💡 Key Findings

A narrative review of adults with epilepsy found that newer antiseizure medications, including cannabidiol (CBD), generally had favourable cognitive profiles at recommended doses.

High

84%

Topiramate and zonisamide remained consistently associated with higher cognitive risks than many newer or other antiseizure medications.

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88%

Eslicarbazepine and cenobamate may cause mild, dose-dependent cognitive effects at the upper end of their recommended dose ranges.

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80%

Older adults and people with intellectual disabilities are particularly vulnerable to cognitive adverse effects, according to the reviewed evidence.

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80%

📄 Original Abstract

Antiseizure medications (ASMs) are the mainstay of epilepsy treatment but may adversely affect cognitive functions, deepening the cognitive and psychosocial burden intrinsic to epilepsy. Cognitive side effects vary widely across drug classes, doses, treatment regimens, and individual susceptibility, typically affecting attention, processing speed, memory, language, and executive function. This narrative review provides an updated synthesis of the clinical evidence on the cognitive effects of ASMs, mostly in adults, building on a prior 2009 review and focusing on agents introduced into clinical practice since then. A literature search of PubMed identified studies published between January 2009 and December 2025, yielding data from randomised controlled trials, observational studies, meta-analyses, and systematic reviews. Overall, newer-generation ASMs, including rufinamide, lacosamide, brivaracetam, cannabidiol, fenfluramine, and ganaxolone, demonstrate generally favourable cognitive profiles when used at recommended doses, particularly in monotherapy or rational polytherapy. Eslicarbazepine and cenobamate may be associated with mild, dose-dependent cognitive effects, occurring only at the upper end of the recommended dose range. In contrast, old ASMs and certain second-generation agents, notably topiramate and zonisamide, remain consistently associated with higher cognitive risks. Special populations, including older adults and individuals with intellectual disabilities, are particularly vulnerable to cognitive adverse effects and benefit from agents with low interaction potential and benign neuropsychological profiles. Cognitive dysfunction in epilepsy is multifactorial, reflecting the interaction between disease-related neurobiological mechanisms and treatment effects. Optimal management requires balancing seizure control with cognitive preservation through individualised drug selection, cautious titration, and minimisation of polytherapy to achieve the best functional and quality-of-life outcomes.