Behavioural Parameters and Drug Effects A Study of a Hyperkinetic Epileptic Child

Abstract

SUMMARY Traditional clinical evaluations of drug effects, with their reliance on global ratings, contrast unfavourably with the sophisticated methods employed in animal studies. In this intensive study of a hyperkinetic epileptic child an attempt was made to evaluate the differential effects of drugs on several behavioural parameters. The drugs investigated were trifluoperazine, thioridazine and sulthiame. Methods of recording and analysing the child's free‐field behaviour are described. Thioridazine was found to increase attention span and constructive activities and to decrease locomotion and destructive activities. Sulthiame increased attention span, and reduced oral and destructive activities to a greater extent than thioridazine. Trifluoperazine was not found to have a significant effect on any of the behavioural parameters. The study demonstrates that a clinical assessment of “improvement” does not denote a desirable change in all behaviours; it is suggested that to specify which parameters are affected and how is more informative and clinically useful. Cine film has proved to be a valuable tool in this kind of behavioural analysis. RÉASUMÉA Les eAtudes cliniques traditionnelles des effets des meAdicaments, s'appuyant sur des reAsultats globaux, supportent mal la comparaison avec les meAthodes eAlaboreAes employeAes dans les eAtudes portant sur l'animal. Dans cette eAtude approfondie d'un enfant comitial hyperkyneAtique, on a chercheA aG eAvaluer les changements des effets des meAdicaments aG l'aide de plusieurs parameGtres deA comportement. Les meAdicaments eAtudieAes eAtaient la trifluoperaxine, la thioridazine et le sulthiame. Les meAthodes d'enregistrement et d'analyse du comportement spontaneA de l'enfant sont deAcrites. On a trouveA que la thioridazine augmentait les capaciteAs d'attention et les activiteAs constructives et diminuait les comportements locomoteurs et de destruction. Le sulthiame augmente plus les capaciteAs d'attention et reAduit plus les activiteAs orales et destructives que la thioridazine. En revanche, on a trouveA que la trifluoperazine n'avait pas d'effet significatif sur aucun des parameGtres de comportement. L'eAtude prouve qu'une eAvaluation clinique d'ameAlioration ne signifie pas un changement positif dans tous les parameGtres de comportement. On suggeGre qu'une speAcification des parameGtres affecteAs et de la facLon d'affection sera plus instructive et utile pour la clinique. La meAthode des films s'est aveAreAe valable pour cette sorte d'eAtude du comportement.

Behavioural Effects of Anti‐epileptic Drugs

“…Greater precision in the description of the mental state is needed if the exact nature of the behavioural complication of the drugs is to be established and the possibility of characteristic effects explored. Hutt et al (1966) emphasised the importance of precise and selective descriptions of different aspects of behaviour, and advocated the abandonment of global clinical impressions which can obscure important, though selective, behavioural change. In their interesting study of the effects of different drugs on the behaviour of a hyperkinetic epileptic child, these authors reported that sulthiame had selectively beneficial effects in that it seemed to increase attention-span and to decrease destructive behaviour, whilst leaving other types of activity unchanged.…”

“…Finally, the reported effects of sulthiame on cognitive function are similarly conflicting. Hutt et al (1966) claimed a seiectively beneficial effect of this drug on sustained attention, but a more recent report (Green et al 1974) suggests that while patients may feel more alert on sulthiame given at usual therapeutic dosage, compared with those on phenytoin they actually perform less efficiently on objective tests.…”