Impact of levetiracetam on mood and cognition during prednisone therapy.
OBJECTIVE
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.


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.
Brown
E Sherwood
ES
The Psychoneuroendocrine Research Program of the Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8849, USA. sherwood.brown@utsouthwestern.edu
Frol
Alan B
AB
Khan
David A
DA
Larkin
Gregory L
GL
Bret
Mary Ellen
ME
D000293:Adolescent; D000328:Adult; D000339:Affect / Q000187:drug effects*; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D003071:Cognition / Q000187:drug effects*; D003866:Depressive Disorder / Q000188:drug therapy*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D008568:Memory / Q000187:drug effects; D008875:Middle Aged; D009483:Neuropsychological Tests; D010889:Piracetam / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use*; D011795:Surveys and Questionnaires
D000893:Anti-Inflammatory Agents; D000928:Antidepressive Agents; D000077287:Levetiracetam; D011241:Prednisone; D010889:Piracetam