Impairment of Vigilance and Performance under Lithium-Treatment Studies in Patients and Normal Volunteers^*

Abstract

Subtle changes of adaptive behaviour under lithium treatment may possess interest not only as side-effects, but also as a possible explanation for the mechanism of action of lithium salts. - In 18 patients under long-term lithium treatment and 10 normal volunteers before and after one week of lithium application the EEG was recorded and performance as well as psychophysiological tests were carried out. The results, particularly of the d-2-test point to a considerably reduced performance in patients and normal volunteers. The EEG data in both groups suggest reduced vigilance until stage B3 or C (in the sense of Head of Bente); CFF was significantly elevated only during the first days of lithium application in the normal volunteers. Whereas EEG changes persist, other symptoms as CFF reduction, fine hand tremor, or reduced performance resolved at least partially 7 days after lithium withdrawal in the normal volunteers.

Fenfluramine stimulation of serum cortisol in patients with major affective disorders and healthy controls: further evidence for a central serotonergic action of lithium in man

“…Fasting Cortisol Concentrations at 8 a.m. Platman and Fieve (1968), Platman et al (1971), Berens and Wolff (1975), Miiller-Oerlinghausen et al (1977), Halmi et al (1978), Czernik and Kleesiek (1979) did not observe any significant differences of basal cortisol plasma concentrations in lithium treated manic-depressive patients, although an initial, but transient rise after acute oral administration was evidenced.…”

“…Although the role of the serotonergic system is far from being elucidated, there is converging evidence that it has homeostatic and pace maker functions (Aghajanian and Wang, 1978) as well as an important role in the circadian periodicity of ACTH and cortisol regulation (Miiller et aL, 1977).…”

“…The circadian cortisol-secretion pattern which is regulated, at least partly, by serotonergic mechanisms (Miiller et al, 1977), was, therefore, investigated under the experimental condition of fenfluramine stimulation (FFS). This drug, fluormethylamphetamine, represents an anorectic agent highly selectively affecting well-known serotonergic pathways ascending from brainstem neurons to the forebrain (Garattini et aL, 1975;Sotdo and Zamora, 1978;Duhault et al, 1975Duhault et al, , 1979.…”

Psychomotor function and psychoactive drugs:

“…The adaptive tracking task is a more refined pursuit and tracking test, which has been shown by Borland & Nicholson (1974) to be sensitive to the effects of heptabarbitone 200, 300 and 400 mg, and Nicholson (1979) has shown the residual sedative activity of flurazepam 30 mg, nitrazepam 10 mg, oxazepam 30 and 45 mg, temazepam 20 mg and diazepam 10 mg. Muller-Oerlinghausen, Bauer, Girke, Kanowski & Goncalves (1977) have also used adaptive tracking tests to detect the impairment of performance produced by lithium salts in both patient and volunteer populations. It is clear that adaptive tracking is a reliable index of the effects of sedative drugs.…”

Lithium Treatment and Memory Assessment: Methodology

“…Mueller-Ocrlinghausen et 114 Engelsmann/Ghadirian/Grof Lithium and Memory Assessment: Methodology al. [ 15] found that patients who had been on lithium treat ment for more than 3 years obtained vigilance and learn ing test scores significantly lower than standardized val ues. Shaw et al [13] used an on-off-on design (the so called B-A-B design), and administered a battery of psy chological tests to 22 euthymic out-patients with affective disorders in remission, during both lithium treatment and blind-placebo substitution.…”