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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).
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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

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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.

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