Edwin Meresh
Background: Chronic alcohol use could lead to withdrawal, delirium and dementia. Alcohol related delirium include delirium tremens, hepatic encephalopathy and Wernicke’s Encephalopathy (WE). Alcohol related dementia include Korsakoff Syndrome (KS). Studies support benefit of anti-epileptics in alcohol withdrawal. There is limited data on their role in alcohol related cognitive disorders. Levetiracetam (LEV) is used for the treatment of seizure disorders. Studies have suggested neuroprotective properties for LEV. The purpose of this review is to discuss the possible use of LEV in alcohol related cognitive disorders.
Methods: PubMed database and relevant publication reference were reviewed. Search terms were: Levetiracetam, Neuroprotection, Piracetam, alcohol induced Cognitive Disorders, Wernicke’s encephalopathy, Korsakoff syndrome.
Results: We identified several studies supporting evidence for LEV helping alcohol withdrawal, offering neuroprotection. We identified 2 studies supporting Piracetam’s efficacy in alcohol related cognitive problems. Piracetam is related to LEV. One study identified alcohol withdrawal patients who were on LEV had shortened Intensive Care Unit (ICU) stay and decreased time mechanically ventilated.
Conclusion: LEV may be the first medication that could cover all complications of alcohol dependence, especially in chronic users who are at risk of cognitive impairment. Could LEV treat WE along with thiamine and other measures?. Could it prevent or delay the progression of WE to KS?. For KS pt, could it decrease the severity?. Prospective studies are needed to see if LEV works in decreasing the cognitive impairment in Wernicke-korsakoff syndrome through neuroprotection.