Impact of levetiracetam on mood and cognition during prednisone therapy

被引:24
作者
Brown, E. Sherwood
Frol, Alan B.
Khan, David A.
Larkin, Gregory L.
Bret, Mary Ellen
机构
[1] Univ Texas SW Med Ctr Dallas, Dept Psychiat, Psychoneuroendocrine Res Program, Dallas, TX 75390 USA
[2] Univ Texas SW Med Ctr Dallas, Dept Psychiat, Neuropsychol Serv, Dallas, TX 75390 USA
[3] Univ Texas SW Med Ctr Dallas, Dept Internal Med, Div Allergy & Immunol, Dallas, TX 75390 USA
[4] Univ Texas SW Med Ctr Dallas, Dept Surg, Div Emergency Med, Dallas, TX 75390 USA
[5] Univ Texas SW Med Ctr Dallas, Baylor Inst Rehabil, Dallas, TX 75246 USA
关键词
anticonvulsant; memory; corticosteroid; mania; depression; hippocampus;
D O I
10.1016/j.eurpsy.2007.06.002
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
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 chance 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. (c) 2007 Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:448 / 452
页数:5
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