EEG Abnormalities Under Treatment with Atypical Antipsychotics: Effects of Olanzapine and Amisulpride as Compared to Haloperidol

 

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Abnormal EEG patterns are well known electrophysiological effects of treatment with antipsychotic drugs. To estimate the risk of EEG alterations including epileptiform activity under recently developed antipsychotics, we have analysed EEG recordings of all inpatients with schizophrenia medicated with atypical antipsychotics olanzapine or amisulpride in monotherapy, in comparison to a control group under haloperidol within a two-year period.

EEG effects of olanzapine (n = 45) and amisulpride (n = 25) were retrospectively investigated and compared with the effects of haloperidol (n = 20) using digital EEG recordings, visually assessed by two independent investigators.

Patients under olanzapine and amisulpride showed significantly higher rates of EEG abnormalities (46.7 and 44 %) as compared to haloperidol (10 %) (p < 0.01, and p < 0.05, respectively) and abnormal EEGs were associated with higher doses of medication. Epileptiform discharges were seen under olanzapine (15 %), and amisulpride (4 %), but not under haloperidol (statistical trend, p = 0.07).

EEG abnormalities are frequent, and dose-dependent findings under treatment with olanzapine and amisulpride, and the occurrence of epileptiform activity has to be taken into account.

References

• 1 Adler G, Grieshaber S, Faude V, Thebaldi B, Dressing H. Clozapine in patients with chronic schizophrenia: serum level, EEG and memory performance.  Pharmacopsychiatry. 2002;  35 190-194
  Article in Thieme ConnectPubMedGoogle Scholar
• 2 Alldredge B K. Seizure risk associated with psychotropic drugs: clinical and pharmacokinetic considerations.  Neurology. 1999;  53(S2) S68-75
  PubMedGoogle Scholar
• 3 Bitter I, Chou J C, Ungvari G S, Tang W K, Xiang Z, Iwanami A, Gaszner P. Prescribing for inpatients with schizophrenia: an international multi-center comparative study.  Pharmacopsychiatry. 2003;  36 143-149
  Article in Thieme ConnectPubMedGoogle Scholar
• 4 Bymaster F P, Rasmussen K, Calligaro D O, Nelson D L, DeLapp N W, Wong D T,. et al . In vitro and in vivo biochemistry of olanzapine: a novel, atypical antipsychotic drug.  J Clin Psychiatry. 1997;  58(S10) 28-36
  PubMedGoogle Scholar
• 5 Centorrino F, Price B H, Tuttle M, Bahk W M, Hennen J, Albert M J. et al . EEG abnormalities during treatment with typical and atypical antipsychotics.  Am J Psychiatry. 2002;  159 109-115
  PubMedGoogle Scholar
• 6 Gaebel W, Janssen B, Riesbeck M. Modern treatment concepts in schizophrenia.  Pharmacopsychiatry. 2003;  36(S3) S168-75
  PubMedGoogle Scholar
• 7 Hamann J, Pfeiffer H, Leucht S, Kissling W. Are patients with schizophrenia undertreated with second-generation antipsychotics? A pilot study of the prescription practices of German psychiatrists.  Pharmacopsychiatry. 2003;  36 309-312
  Article in Thieme ConnectPubMedGoogle Scholar
• 8 Hughes J R, John E R. Conventional and quantitative electroencephalography in psychiatry.  J Neuropsychiatry Clin Neurosci. 1999;  11 190-208
  PubMedGoogle Scholar
• 9 Schuld A, Kühn M, Haak M, Kraus T, Hinze-Selch D, Lechner C. et al . A comparison of the effects of clozapine and olanzapine on the EEG in patients with schizophrenia.  Pharmacopsychiatry. 2000;  33 109-111
  Article in Thieme ConnectPubMedGoogle Scholar
• 10 Small J G, Milstein V, Small I F, Miller M J, Kellams J J, Corsaro C J. Computerized EEG profiles of haloperidol, chlorpromazine, clozapine and placebo in treatment resistant schizophrenia.  Clin Electroencephalogr. 1987;  18 124-135
  PubMedGoogle Scholar

Oliver Pogarell, M.D.

Department of Psychiatry

Section of Clinical Neurophysiology

Ludwig-Maximilians-University of Munich

Nussbaumstr. 7

80336 Munich

Germany

Phone: +49 89 5160 3409

Fax: +49 89 5160 5542

Email: oliver.pogarell@med.uni-muenchen.de