Tipik ve Atipik Antipsikotik İlaç Kullanımına Bağlı EEG Anormallikleri

Türkçe

Aim: Typical antipsychotics and clozapine could cause EEG abnormalities and risk of epileptic seizures. Little is known about the effects of newer antipsychotics on EEG. The present study therefore examined the risk of EEG abnormalities associated with the use of atypical antipsychotics [clozapine, quetiapine, risperidone, olanzapine and new atypical antipsychotics (amisulpride, aripiprazole, paliperidone)] and of the typical antipsychotics (chlorpromazine, haloperidol, zuclopenthixol, pimozide). Materials and Methods : EEG patterns were prospectively investigated in 102 patients with schizophrenia or schizoaffective disorders. While 82 out of the 102 patients were under atypical [clozapine (n=16), risperidone (n=20), quetiapine (n=10), olanzapine (n=14), and new atypical antipsychotics (n=10)] and typical [haloperidol (n=5), chlorpromazine (n=2), zuclopenthixol (n=3), pimozide (n=2)] antipsychotic treatment, 20 of them were not under any treatment. These three groups were compared with a sex- and aged- matched control group of healthy volunteers (n=29). Results: No statistically significant difference regarding demographic characteristics was found between the groups. Both the patients who were not on any medication and the healthy volunteers had normal EEG’s . Epileptic activity was observed in 31.3% of the patients under clozapine treatment (p<0.05) and in 10% of the patients under quetiapine treatment (p>0.05). EEG abnormalities other than epileptic activity were observed in 58.3% of the patients under typical antipsychotics (p<0.01) and 35% of the patients under risperidone treatment (p<0.01). EEG was normal in 78–80% of the patients using quetiapine and new atypical antipsychotics, compared to 33.3% of the patients under typical antipsychotic treatment (p=0.012). Discussion and Conclusion: Herein, we found that clozapine was the most epileptogenic antipsychotic and that typical antipsychotics were making the worse EEG changes. Nevertheless, in the psychotic patients under clozapine treatment EEG is a must. Psychotic patients with consequential epilepsy could be given new atypical antipsychotics because it has the least unwanted effects on EEG. Moreover, it should also be emphasized that there is a need for further scientific research to clarify all aspects characterizing the complex link between seizure threshold and psychotropic drugs.