Source Department of Medicine, Cedars-Sinai Medical Center, 8635 West Third Street, Suite 1060, Los Angeles, CA 90048, USA; Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

Hepatic encephalopathy (HE) is a potentially reversible state of impaired cognitive function or altered consciousness in patients with liver disease or portosystemic shunting. Overt HE is a particularly pressing problem. Given the many targets of treatment and lack of a clear singular cause of overt HE, there is no consensus on a single best treatment. Over the past several years, high-quality studies have been conducted on the various pharmacologic therapies for HE and, as more data emerge, hopefully HE will become a much more easily treated complication of decompensated liver disease.