Psychotropic Drugs and the Human EEG. Modem Problems of Pharmacopsychiatry. Vol. 8

Transcription

1 Psychotropic Drugs and the Human EEG Modem Problems of Pharmacopsychiatry Vol. 8 Series Editors : Th. Ban, Montreal, Que. F. A. Freyhan, Washington, D.C. P. Pichot, Paris W. PÖLDINGER, Vienna S. Karger Basel München Paris London New York Sydney Psychotropic Drugs and the Human EEG Volume Editor : Turan M. Itil, New York, N.Y. With 95 figures and 19 tables, 1974 S. Karger Basel München Paris London New York Sydney Modem Problems of Pharmacopsychiatry Vol. 1: Clinical Psychopharmacology / Klinische Psychopharmakologie / Psychopharmacologie Clinique. X+284 p., 26 fig., 27 tab., 1968 ISBN Vol. 2: The Thioxanthenes. X+116 p., 27 fig., 12 tab., 1969 ISBN Vol.3: N.S. Kline (Orangebourg, N. Y.): Depression: Its Diagnosis and Treatment. Lithium: The History of its Use in Psychiatry. XIII + 92 p., 14 tab., 1969 ISBN Vol. 4: Epilepsy. VII+ 337 p., 40 fig., 40 tab., 1970 ISBN Vol. 5: The Neuroleptics. X+190 p., 38 fig., 9 tab., 1970 ISBN Vol. 6 : The Role of Drugs in Community Psychiatry. VI +128 p., 3 fig., 3 tab., 1971 ISBN Vol. 7: Psychological Measurements in Psychopharmacology. VI+ 267 p., 25 fig., 54 tab.,

2 1974 ISBN Vol. 9: Trazodone. VI p., 86 fig., 83 tab., 1974 ISBN S. Karger Basel München Paris London New York Sydney Arnold-Böcklin-Strasse 25, CH-4011 Basel (Switzerland) All rights, including that of translation into other languages, reserved. Photomechanic reproduction (photocopy, microcopy) of this book or parts of it without special permission of the publishers is prohibited. Copyright 1974 by S. Karger AG, Verlag für Medizin und Naturwissenschaften, Basel Printed in Switzerland by Graphische Betriebe Coop Schweiz, Basel Blocks: Steiner & Co., Basel ISBN Table of Contents Preface VII Acknowledgments X I. Qualitative Awake EEG Findings Borenstein, P. and Cujo, P. (Villejuif): Effects of Major Tranquilizers on the Resting EEG 1 Murphree, Henry B. (Piscataway, N. J.) : Electroencephalographic Effects of Caffeine, Nicotine, Tobacco Smoking, and Alcohol 22 Flügel, Kurt A. (Erlangen): EEG Effects of Circulatory Drugs with Psychotropic Action 37 II. Quantitative Awake EEG Findings Itil, Turan M. (New York, N.Y.): Quantitative Pharmaco-Electroencephalography. Use of Computerized Cerebral Biopotentials in Psychotropie Drug Research. 43 Fink, Max (New York, N.Y.): EEG Profiles and Bioavailability Measures of Psychoactive Drugs 76 Caille, Emile-Jean (Toulon Naval) : Psychotropic Drug-Induced EEG Changes Based on Power Spectrum Analysis 99 Saito, Masami (Moriguchi, Osaka) : Effects of Psychotropic Drugs on the Human EEG Based on Analog Frequency Analysis 117 Goldstein, Leonide (Piscataway, N. J.) : Psychotropic Drug-Induced EEG Changes as Revealed by the Amplitude Integration Method 131

3 Marjerrison, Gordon (Saskatoon, Sask.) : Effects of Minor Tranquilizers on the EEG 149 III. Qualitative Sleep EEG Findings Jovanovic, U. J. (Würzburg) : Rating Scale for Drug Effects on Sleep Electroencephalograms. Ten Categories of Psychopharmacological Agents 158 Contents VI Borenstein, P. and Cujo, P. (Villejuif): Influence of Barbiturates and Benzodiazepines on the Sleep EEG 182 IV. Quantitative Sleep EEG Findings Itil, Turan M. ; Saletu, B., and Akpinar, S. (New York, N. Y.) : Classification of Psychotropic Drugs Based on Digital Computer Sleep Prints 193 V. Desynchronized Sleep EEG Findings Hartmann, Ernest (Boston, Mass.) : Effect of Psychotropic Drugs on Desynchronized Sleep 216 VI. Subcortical EEG Findings Monroe, Russell R. (Baltimore, Md.) : Drug Effects on Subcortical Electrograms in Humans 228 VII. Evoked Potential Findings Shagass, Charles (Philadelphia, Pa.): Effects of Psychotropic Drugs on Human Evoked Potentials 238 Saletu, Bernd (St. Louis, Mo.) : Classification of Psychotropic Drugs Based on Human Evoked Potentials 258 VIII. Clinical EEG Correlations Robinson, S. (Jerusalem): Relationship between EEG and Behavior 286 Dasberg, H. (Jerusalem) : EEG as an Outcome Measurement in Treatment with Antipsychotic Psychopharmaca 301 Helmchen, H. (Berlin): Significance of Psychotropic Drug-Induced Abnormal EEGs 317 IX. Statistical Analyses of EEG Data Shapiro, Donald M. and Glasser, Marvin (New York, N.Y.): Measurement and

4 Comparison of EEG-Drug Effects 327 Mucciardi, Anthony N. (McLean, Va.): New Computational Techniques in the Evaluation of Drug-Induced EEG Changes 350 Preface Turan M. Itil It is a singular tragedy that the person who suggested and inspired this volume, Prof. Dr. N. Petrilowitsch, is no longer with us. His suggestion that I edit a monograph concerning drugs and the EEG was more than welcome to me. The application of electroencephalography in the field of psychiatry has been looked at with a certain degree of skepticism, even though 40 years ago Berger demonstrated the existence of physiological correlates of some psychological phenomena and established the effects of psychoactive drugs on brain waves. Perhaps due to hopelessness as a result of the lack of a viable methodology in psychiatry, only a small group of investigators, Fink, Borenstein and Goldstein just to name a few, have not been discouraged by general skepticism and have systematically studied the effects of psychotropic drugs on the EEG. Since the symposium concerning EEG and psychopharmacology, which was organized by Max Fink during the World Congress of Psychiatry in 1961, no major efforts have been made to gather the investigators and the studies concerning psychotropic drugs and the human EEG. While the first 10 years of researching the EEG and psychopharmacology were somewhat hampered by the seemingly contradictory results of some animal studies regarding socalled dissociation of EEG and behavior, the major breakthroughs in EEG and drug research have been the application of analytical techniques and the use of sleep activation. In part due to a space limitation and partly in order to collect the most recent results, only investigators who are still actively working in EEG and human psychopharmacology research have been invited to contribute to this monograph which includes nine chapters. Chapter I covers the qualitative awake EEG findings. In this chapter, Dr. Borenstein and Dr. Cujo describe Preface VIII the effects of major tranquilizers on the problem of EEG classification of psychotropic drugs. Dr. Murphree summarizes his own findings and reviews the literature regarding the EEG effects of non classical psychotropic drugs, such as caffeine, nicotine, tobacco smoking, and alcohol. Dr. Flügel describes the effects of some circulatory drugs with psychotropic action. Chapter

5 II reports the findings with psychotropic drugs based on different EEG quantification methods. The implementation of digital computer period analysis in order to characterize EEG profiles and the bioavailability measures of different psychotropic drugs are demonstrated by Dr. Fink. The use of a new method, so-called quantitative pharmaco-eeg, with the application of computer analysis of the EEG in the screening of new psychotropic drugs is described by us. Power spectrum analysis in psychopharmacology is the topic of Dr. Caille and the application of the analog frequency analyzer is reported by Dr. Saito. The use of the amplitude integration method in psychotropic drug research is described by Dr. Goldstein, with specific emphasis on minor tranquilizers by Dr. Marjerrison. Chapter III includes the effects of psychotropic drugs on the sleep EEG as evaluated visually. In this chapter, Dr. Jovanovic attempts to classify psychotropic drugs based on different characteristics of the sleep process ; Dr. Borenstein and Dr. Cujo describe the effects of different benzodiazepines and barbiturates on the sleep EEG. In the IVth chapter, we attempt to classify psychotropic drugs based on computer-classified sleep stages and REM activity. Dr. Hartmann outlines the effects of various classes of drugs on desynchronized sleep (d-time or REM time) in chapter V. In the Vlth chapter, Dr. Monroe describes the effects of psychotropic drugs on the subcortical EEG in humans. In chapter VII, the effects of psychotropic drugs on the human evoked potential are described by Dr. Shagass and a classification of psychoactive drugs based on human evoked potentials is reported by Dr. Saletu. Chapter VIII relates to the clinical significance of EEG alterations. In this chapter, Dr. Robinson discusses the relationship between EEG and behavior, Dr. Dasberg the role of the EEG as an outcome measurement, and Dr. Helmchen the significance of abnormal EEGs induced by psychotropic drugs. The IXth and final chapter includes the statistical treatments of quantitative EEG data. While Dr. Shapiro and Dr. Glasser describe sophisticated conventional statistical techniques to determine psychotropic drug effects on the human EEG, Dr. Mucciardi describes new, rather unorthodox, techniques in the evaluation of druginduced EEG changes. It is to be expected that the reader will find some controversial results and/or ideas within the contributions to this monograph. However, the results Preface IX of quantitative EEG and sleep investigations are rather unique and very encouraging. We believe further improvement in the recording and analyzing techniques involving human cerebral biopotentials (such as very high frequency activities) and the application of new statistical approaches (for example, nonlinear statistics) to the data would significantly contribute to

6 EEG and drug research. If this monograph can at least stimulate some interest among young scientists who are open to new ideas, it will have achieved its purpose. Author s address : Dr. T. M. Itil, Research Professor and Director, Division of Biological Psychiatry, New York Medical College, Department of Psychiatry, 5th Avenue 106th Street, New York, N. Y. (USA) Acknowledgments In the completion of this monograph, in addition to the contributors to whom I am very thankful for the prompt delivery of their manuscripts, several of my associates worked very hard. First of all I would like to thank very much Mr. Barry Bergey, my long-term and loyal editorial assistant, who professionally edited the manuscripts and put the papers in the requested style. The several retypings of the material in a correct and expedient way was only possible due to the hard work of my efficient secretaries, Mrs. Kathy Black, Mrs. Diane Steinert and Mrs. Doris Zabel. My appreciation and thanks.