Effect of phenytoin on mood and declarative memory during prescription corticosteroid therapy

Brown, E. Sherwood; Stuard, Gary; Hukovic, Nedim; Frol, Alan B.; Dhanani, Nafisa; Khan, David A.; Jeffress, Jala; Larkin, Gregory Luke; McEwen, Bruce S.; Rosenblatt, Randall L.; Mageto, Yolanda; Hanczyc, Margaret; Cullum, C. Munro

doi:10.1016/j.biopsych.2004.11.021

Cited by 31 publications

(18 citation statements)

References 43 publications

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“…Two more recent prevention trials have been reported in patients receiving short‐term prednisone “bursts.” The glutamate release inhibitor and anti‐seizure medication phenytoin was associated with a smaller increase than placebo in self‐reported manic/hypomanic symptoms, with no differences in depressive symptoms or declarative memory, when initiated concurrently with prednisone at a mean dose of approximately 40 mg/day for approximately 7 days 79 . Levetiracetam is an anti‐seizure medication that shows neuroprotective properties in animal models of ischemia 80 and kainic acid‐induced toxicity, 81 and decreases in glutamate‐induced excitotoxicity in an animal model of seizures 82 .…”

Section: Risk Factors For Corticosteroid‐induced Psychiatric Symptomsmentioning

confidence: 96%

Effects of Glucocorticoids on Mood, Memory, and the Hippocampus

Brown

2009

Annals of the New York Academy of Sciences

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198

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Corticosteroids, such as prednisone and dexamethasone, are commonly prescribed medications that suppress the immune system and decrease inflammation. Common side effects of long-term treatment with corticosteroids include weight gain, osteoporosis, and diabetes mellitus. This paper reviews the literature on psychiatric and cognitive changes during corticosteroid therapy and potential treatment options. Hypomania and mania are the most common mood changes during acute corticosteroid therapy, although depression has also been reported. However, depression is reported to be more common than mania during long-term treatment with corticosteroids. A decline in declarative and working memory is also reported during corticosteroid therapy. Corticosteroids are associated with changes in the temporal lobe, detected by structural, functional, and spectroscopic imaging. The mood and cognitive symptoms are dose dependent and frequently occur during the first few weeks of therapy. Other risk factors are not well characterized. Controlled trials suggest that lithium and phenytoin can prevent mood symptoms associated with corticosteroids. Lamotrigine and memantine also have been shown to reverse, at least partially, the declarative memory effects of corticosteroids. Uncontrolled trials suggest that antipsychotics, anti-seizure medications, and perhaps some antidepressants can also be useful for normalizing mood changes associated with corticosteroids. Thus, both the symptoms and treatment response are similar to those of bipolar disorder. Moreover, corticosteroid-induced mood and cognitive alterations have been shown to be reversible with dose reduction or discontinuation of treatment.

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Section: Risk Factors For Corticosteroid‐induced Psychiatric Symptomsmentioning

confidence: 96%

Effects of Glucocorticoids on Mood, Memory, and the Hippocampus

Brown

2009

Annals of the New York Academy of Sciences

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198

119

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“…13 Anti convulsants have not been shown to be effective in preventing corticosteroid-induced psychosis. [14][15][16] Conclusion This case is an interesting example of psychosis induced by administration of a high dose of corticosteroid. Symptoms arose quickly and were long-lasting and challenging, requiring complex management.…”

Section: Louisa Ward Mbchb Joji George Mbbs Mrcpsychmentioning

confidence: 99%

Corticosteroid-induced psychosis in rheumatoid arthritis

Ward¹,

George²

2016

Prog. Neurol. Psychiatry

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“…Phenytoin has been shown to be mildly effective in preventing manic symptoms following corticosteroids in a small randomized controlled trial, although it was not clinically significant [29]. Phenytoin interacts with corticosteroids by competing for protein binding increasing the free percentage of both drugs.…”

Section: Anticonvulsantsmentioning

confidence: 99%

“…There are examples of the same agents being used in the transplant population [20,21]. This article presents a case report with review of the literature regarding strategies, pharmacological (Tables 1 and 2) [22][23][24][25][26][27][28][29][30][31][32][33] and nonpharmacological, to prevent these complications. This article presents a case report with review of the literature regarding strategies, pharmacological (Tables 1 and 2) [22][23][24][25][26][27][28][29][30][31][32][33] and nonpharmacological, to prevent these complications.…”

Section: Introductionmentioning

confidence: 99%

Strategies to prevent the neuropsychiatric side-effects of corticosteroids

West

Kenedi

2014

Current Opinion in Organ Transplantation

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There is a lack of large randomized controlled studies to inform clinical practice. At present, lithium and olanzapine probably represent the best choices for prophylaxis. Patients with a prior history of steroid-related psychosis or mania should be considered for prophylaxis when future courses of steroids are prescribed as limited data, and our clinical experience suggests that this can reduce the future episodes of neuropsychiatric side-effects.

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Effect of phenytoin on mood and declarative memory during prescription corticosteroid therapy

Cited by 31 publications

References 43 publications

Effects of Glucocorticoids on Mood, Memory, and the Hippocampus

Effects of Glucocorticoids on Mood, Memory, and the Hippocampus

Corticosteroid-induced psychosis in rheumatoid arthritis

Strategies to prevent the neuropsychiatric side-effects of corticosteroids

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