Hostname: page-component-55f67697df-q9hcs Total loading time: 0 Render date: 2025-05-21T00:43:16.607Z Has data issue: false hasContentIssue false
  • English
  • Français

Impact of levetiracetam on mood and cognition during prednisone therapy

Published online by Cambridge University Press:  04 September 2007

E. Sherwood Brown ,
Alan B. Frol ,
David A. Khan ,
Gregory L. Larkin  and
Mary Ellen Bret
E. Sherwood Brown*
Affiliation:
The Psychoneuroendocrine Research Program of the Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8849, USA
Alan B. Frol
Affiliation:
Neuropsychology Service of the Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA Baylor institute for Rehabilitation, University of Texas Southwestern Medical Center, 3505 Gaston Avenue, Dallas, TX 75246, USA
David A. Khan
Affiliation:
The Division of Allergy and Immunology of the Department of internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
Gregory L. Larkin
Affiliation:
The Division of Emergency Medicine of the Department of Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
Mary Ellen Bret
Affiliation:
The Psychoneuroendocrine Research Program of the Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8849, USA
*
∗Corresponding author. Tel.: +1 214 645 6950; fax: +1 214 645 6951. E-mail addresses: sherwood.brown@utsouthwestern.edu (E.S. Brown), alan.frol@utsouthwestern.edu (A.B. Frol), dave.khan@utsouthwestern.edu (D.A. Khan), gregory.larkin@utsouthwestern.edu (G.L. Larkin), mary.bret@utsouthwestern.edu (M.E. Bret).
Get access

Abstract

Purpose

Corticosteroid excess is associated with impairment in declarative memory and hippocampal changes. in animals, phenytoin blocks the effects of stress on memory and hippocampal histology. Levetiracetam also shows neuroprotective properties in some animal models. This report examines whether levetiracetam prevents mood or cognitive changes secondary to prescription corticosteroids.

Materials and methods

Thirty outpatients given systemic corticosteroid therapy for asthma were randomized to either levetiracetam (1500 mg/day) or placebo given concurrently with the corticosteroids. Mood was assessed with the Hamilton rating scale for depression (HRSD), Young mania rating scale (YMRS) and activation (ACT) subscale of the internal state scale, declarative memory with the Rey auditory verbal learning test (RAVLT), and attention and executive functioning with the Stroop color and word test at baseline and after approximately 7 days of corticosteroid plus levetiracetam or placebo therapy.

Results

Levetiracetam and placebo groups showed significant improvement from baseline to exit on RAVLT total words recalled with a non-significant change on other outcomes. No significant between-group differences were found. initial prednisone dose showed a significant correlation with change in some cognitive domains.

Conclusions

Levetiracetam was well tolerated when combined with prednisone. Significant between-group differences in mood and cognition were not found.

Keywords

anticonvulsantMemoryCorticosteroidManiaDepressionHippocampus
Type
Original article
Information
European Psychiatry , Volume 22 , Issue 7 , October 2007 , pp. 448 - 452
Copyright
Copyright © Elsevier Masson SAS 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

1

Tel.: +1 214 648 4646; fax: +1 214 648 4660.

2

Tel.: +1 214 648 3004; fax: +1 214 648 9102.

3

Tel.: +1 214 648 2904; fax: +1 214 648 2905.

4

Tel.: +1 214 645 6964; fax: +1 214 645 6951.

References

Bauer, M.S., Crits-Christoph, P., Ball, W.A., Dewees, E., McAllister, T., Alahi, P.et al.independent assessment of manic and depressive symptoms by self-rating. Scale characteristics and implications for the study of mania. Arch Gen Psychiatry 1991;48:807–812.CrossRefGoogle Scholar
Bersani, G.Levetiracetam in bipolar spectrum disorders: first evidence of efficacy in an open, add-on study. Hum Psychopharmacol 2004;19:355–356.CrossRefGoogle Scholar
Brown, E.S., Frol, A., Bobadilla, L., Nejtek, V.A., Perantie, D.C., Dhillon, H.Effect of lamotrigine on mood and cognition in patients receiving chronic exogenous corticosteroids. Psychosomatics 2003;44:204–208.CrossRefGoogle ScholarPubMed
Brown, E.S., Rush, A.J., McEwen, B.S.Hippocampal remodeling and damage by corticosteroids: Implications for mood disorders. Neuropsychopharmacology 1999;21:474–484.CrossRefGoogle ScholarPubMed
Brown, E.S., Stuard, G., Liggin, J.D., Hukovic, N., Frol, A., Dhanani, N.et al.Effect of phenytoin on mood and declarative memory during prescription corticosteroid therapy. Biol Psychiatry 2005;57:543–548.CrossRefGoogle ScholarPubMed
Brown, E.S., Suppes, T., Khan, D.A., Carmody, T.J.Mood changes during prednisone bursts in outpatients with asthma. J Clin Psychopharmacol 2002;22:55–61.CrossRefGoogle ScholarPubMed
Brown, E.S., Woolston, D.J., Frol, A., Bobadilla, L., Khan, D.A., Hanczyc, M.et al.Hippocampal volume, spectroscopy, cognition, mood in patients receiving corticosteroid therapy. Biol Psychiatry 2004;55:538–545.CrossRefGoogle ScholarPubMed
Conrad, C.D., Galea, L.A.M., Kuroda, Y., McEwen, B.S.Chronic stress impairs rat spatial memory on the Y maze, this effect is blocked by tianeptine pretreatment. Behav Neurosci 1996;110:1321–1334.CrossRefGoogle Scholar
Golden, C.J., Freshwater, S.M.The Stroop color and word test: a manual for clinical and experimental uses. Wood Dale, IL: Stoelting Co; 2002.Google Scholar
Hajek, T., Kopecek, M., Preiss, M., Alda, M., Hoschl, C.Prospective study of hippocampal volume and function in human subjects treated with corticosteroids. Eur Psychiatry 2006;21:123–128.CrossRefGoogle ScholarPubMed
Hamilton, M.A rating scale for depression. J Neurol Neurosurg Psychiatr 1960;23:56–62.CrossRefGoogle ScholarPubMed
Hanon, E., Klitgaard, H.Neuroprotective properties of the novel antiepileptic drug levetiracetam in the rat middle cerebral artery occlusion model of focal cerebral ischemia. Seizure 2001;10:287–293.CrossRefGoogle ScholarPubMed
Keenan, P.A., Jacobson, M.W., Soleymani, R.M., Mayes, M.D., Stress, M.E., Yaldoo, D.T.The effect on memory of chronic prednisone treatment in patients with systemic disease. Neurology 1996;47:1396–1402.CrossRefGoogle ScholarPubMed
Luine, V., Villegas, M., Martinez, C., McEwen, B.S.Repeated stress causes reversible impairments of spatial memory performance. Brain Res 1994;639:167–170.CrossRefGoogle ScholarPubMed
Magarinos, A.M., Deslandes, A., McEwen, B.S.Effects of antidepressants and benzodiazepine treatments on the dendritic structure of CA3 pyramidal neurons after chronic stress. Eur J Pharmacol 1999;371:113–122.CrossRefGoogle ScholarPubMed
Magarinos, A.M., McEwen, B.S., Flugge, G., Fuchs, E.Chronic psychosocial stress causes apical dendritic atrophy of hippocampal CA3 pyramidal neurons in subordinate tree shrews. J Neurosci 1996;16:3534–3540.CrossRefGoogle ScholarPubMed
Marini, H., Costa, C., Passaniti, M., Esposito, M., Campo, G.M., Ientile, R.et al.Levetiracetam protects against kainic acid-induced toxicity. Life Sci 2004;74:1253–1264.CrossRefGoogle ScholarPubMed
Naber, D., Sand, P., Heigl, B.Psychopathological and neuropsychological effects of 8-days' corticosteroid treatment. A prospective study. Psychoneuroendocrinology 1996;21:25–31.CrossRefGoogle ScholarPubMed
Newcomer, J.W., Selke, G., Melson, A.K., Hershey, T., Craft, S., Richards, K.et al.Decreased memory performance in healthy humans induced by stress-level cortisol treatment. Arch Gen Psychiatry 1999;56:527–533.CrossRefGoogle ScholarPubMed
Post, R.M., Altshuler, L.L., Frye, M.A., Suppes, T., McElroy, S.L., Keck, P.E. Jr.et al.Preliminary observations on the effectiveness of levetiracetam in the open adjunctive treatment of refractory bipolar disorder. J Clin Psychiatry 2005;66:370–374.CrossRefGoogle ScholarPubMed
Schmidt, M.Rey auditory verbal learning test (RAVLT): a handbook. Los angeles, CA: Western Psychological Services; 1996.Google Scholar
Starkman, M.N., Gebarski, S.S., Berent, S., Schteingart, D.E.Hippocampal formation volume, memory dysfunction, cortisol levels in patients with Cushing's syndrome. Biol Psychiatry 1992;32:756–765.CrossRefGoogle ScholarPubMed
Starkman, M.N., Giordani, B., Gebarski, S.S., Berent, S., Schork, M.A., Schteingart, D.E.Decrease in cortisol reverses human hippocampal atrophy following treatment of Cushing's disease. Biol Psychiatry 1999;46:1595–1602.CrossRefGoogle ScholarPubMed
Ueda, Y., Doi, T., Nagatomo, K., Tokumaru, J., Takaki, M., Willmore, I.J.Effect of levetiracetam on molecular regulation of hippocampal glutamate GABA transporters in rats with chronic seizures by amygdalar FeCl3injection. Brain Res 2007;1151:55–61.CrossRefGoogle Scholar
Watanabe, Y., Gould, E., Daniels, D.C., Cameron, H., McEwen, B.S.Tianeptine attenuates stress-induced morphological changes in the hippocampus. Eur J Pharmacol 1992;222:157–162.CrossRefGoogle ScholarPubMed
Wolkowitz, O.M., Rubinow, D., Doran, A.R., Breier, A., Berrettini, W.H., Kling, M.A.et al.Prednisone effects on neurochemistry and behavior. Arch Gen Psychiatry 1990;47:963–968.CrossRefGoogle ScholarPubMed
Young, R., Biggs, J., Meyer, D.A rating scale for mania: reliability, validity, and sensitivity. Br J Psychiatry 1978;133:429–435.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.