Antiseizure medication in patients with meningioma: a retrospective cohort study on the long-term impact on depression, anxiety and neurocognitive functioning

Category	Detail
Condition	Meningioma with associated seizures
Key Mechanisms	Antiseizure medications (ASM) impact on mood, anxiety, and neurocognitive function
Target Population	Adult meningioma patients post-primary antitumor treatment (≥5 years)
Care Setting	Neuro-oncology outpatient and follow-up clinics

Over one third of meningioma patients experience seizures during disease course.
Levetiracetam is the most commonly used ASM in brain tumor-related epilepsy due to minimal drug interactions.
Conflicting evidence exists on ASM effects on depression, anxiety, and cognition in meningioma patients.

Use neurocognitive test batteries assessing six domains with Z-score ≤ -1.5 indicating deficits.
Screen for depression and anxiety using Hospital Anxiety and Depression Scale (HADS), with scores ≥8 indicating presence.

Prescribe ASM after a single seizure in intracranial tumor patients per guidelines.
Prefer levetiracetam in brain tumor-related epilepsy to minimize drug interactions, especially in glioma patients.
Consider mood-stabilizing ASMs such as valproic acid or lamotrigine if mood symptoms present.

Levetiracetam may be associated with anxiety and depression in epilepsy patients.
Enzyme-inducing ASMs like phenytoin may cause cognitive dysfunction.
Limited evidence on ASM impact specifically in meningioma patients necessitates cautious interpretation.

Adults with histologically confirmed or suspected intracranial meningioma, post-primary treatment ≥5 years

Levetiracetam is preferred due to fewer drug interactions; however, its association with mood symptoms remains inconclusive in meningioma patients.

Assess neurocognitive function using standardized test batteries with reference to normative data.
Screen for depression and anxiety using validated scales like HADS in meningioma patients on ASM.
Tailor ASM choice considering potential neuropsychiatric side effects and drug interaction profiles.
Exclude patients with confounding neurological or language impairments when evaluating ASM effects.
Use multidisciplinary approach integrating neuro-oncology, neuropsychology, and psychiatry for comprehensive care.

Clinical Scorecard: Long-term Effects of Antiseizure Therapy on Depression, Anxiety, and Neurocognitive Function in Meningioma Patients: A Retrospective Cohort Analysis