TY - JOUR
T1 - Effects of phenytoin on memory, cognition and brain structure in post-traumatic stress disorder
T2 - A pilot study
AU - Bremner, J. Douglas
AU - Mletzko, Tanja
AU - Welter, Silke
AU - Quinn, Sinead
AU - Williams, Chanda
AU - Brummer, Marijn
AU - Siddiq, Sajid
AU - Reed, Lai
AU - Heim, Christine M.
AU - Nemeroff, Charles B.
PY - 2005/3
Y1 - 2005/3
N2 - Phenytoin (Dilantin®) is an anticonvulsant used in the treatment of epilepsy. It is believed to act by modulation of glutamatergic transmission. Because the neurobiology of post-traumatic stress disorder (PTSD) has been hypothesized to involve alterations in glutamatergic transmission with subsequention neurotoxicity, we assessed the effects of phenytoin on cognition and brain structure in PTSD patients. Phenytoin was administered in an open label fashion for 3 months to nine adult patients with PTSD related to a variety of traumas, including early abuse, combat and car accidents. Subjects underwent magnetic resonance imaging for measurement of whole brain and hippocampal volume, and neuropsychological testing of memory and cognition, before and after treatment. Phenytoin treatment resulted in a significant 6% increase in right brain volume (p < 0.05). Increased hippocampal volume was correlated with reductions in symptom severity as measured by the Clinician Administered PTSD Scale and improvements in executive function as measured by the Trails test. However, treatment associated improvements in memory and cognition did not achieve statistical significance. These findings suggest that phenytoin treatment may be associated with changes in brain structure in patients with PTSD.
AB - Phenytoin (Dilantin®) is an anticonvulsant used in the treatment of epilepsy. It is believed to act by modulation of glutamatergic transmission. Because the neurobiology of post-traumatic stress disorder (PTSD) has been hypothesized to involve alterations in glutamatergic transmission with subsequention neurotoxicity, we assessed the effects of phenytoin on cognition and brain structure in PTSD patients. Phenytoin was administered in an open label fashion for 3 months to nine adult patients with PTSD related to a variety of traumas, including early abuse, combat and car accidents. Subjects underwent magnetic resonance imaging for measurement of whole brain and hippocampal volume, and neuropsychological testing of memory and cognition, before and after treatment. Phenytoin treatment resulted in a significant 6% increase in right brain volume (p < 0.05). Increased hippocampal volume was correlated with reductions in symptom severity as measured by the Clinician Administered PTSD Scale and improvements in executive function as measured by the Trails test. However, treatment associated improvements in memory and cognition did not achieve statistical significance. These findings suggest that phenytoin treatment may be associated with changes in brain structure in patients with PTSD.
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U2 - 10.1177/0269881105048996
DO - 10.1177/0269881105048996
M3 - Article
C2 - 15728437
AN - SCOPUS:20244379885
SN - 0269-8811
VL - 19
SP - 159
EP - 165
JO - Journal of Psychopharmacology
JF - Journal of Psychopharmacology
IS - 2
ER -