Quantitative Resting State Electroencephalography in Patients with Schizophrenia Spectrum Disorders Treated with Strict Monotherapy Using Atypical Antipsychotics

Abstract

Objective: The effect of antipsychotic drugs on quantitative electroencephalography (EEG) has been mainly examined by the administration of a single test dose or among patients using combinations of other psychotropic drugs. We therefore investigated the effects of strict monotherapy with antipsychotic drugs on quantitative EEG among schizophrenia patients. Methods: Data from 2,364 medical reports with EEG results from psychiatric patients admitted to the Hokkaido University Hospital were used. We extracted EEG records of patients who were diagnosed with schizophrenia spectrum disorders and who were either undergoing strict antipsychotic monotherapy or were completely free of psychotropic drugs. The spectral power was compared between drug-free patients and patients using antipsychotic drugs. We also performed multiple regression analysis to evaluate the relationship between spectral power and the chlorpromazine equivalent daily dose of antipsychotics in all the patients. Results: We included 31 monotherapy and 20 drug-free patients. Compared with drug-free patients, patients receiving antipsychotic drugs demonstrated significant increases in theta, alpha and beta power. When patients taking different types of antipsychotics were compared with drug-free patients, we found no significant change in any spectrum power for the aripiprazole or blonanserin groups. Patients taking risperidone demonstrated significant increases in alpha and beta power. Patients taking clozapine and olanzapine demonstrated significant slow wave increases. Multiple regression analysis revealed that the chlorpromazine equivalent dose was positively associated with theta power. Conclusion: Use of any antipsychotic drug by patients was associated with a dose-dependent increase in theta power. However, each type of antipsychotic demonstrated different spectral power changes.

Efficacy of aripiprazole as adjunctive therapy in major depressive disorder with somatic symptoms: A randomized, double-blind, placebo-controlled trial with clinical and electroencephalography evidence

“…Another study suggested that the aripiprazole concentration trend was associated with delta activity only in patients with specific CYP2D6 genotypes (Kim et al, 2006). According to a recent study that analyzed the effect of atypical antipsychotics on qEEG using medical data of 2364 psychiatric patients, aripiprazole was not related to spectral band power (Ozaki et al, 2021).…”

Assessment of electroencephalography modification by antipsychotic drugs in patients with schizophrenia spectrum disorders using frontier orbital theory: A preliminary study

“…Exclusion criteria were as follows: aged <13 years, epilepsy, brain tumor, stroke, traumatic brain injury, previous drug overdose leading to coma, and treatment with electroconvulsive therapy in the 4 months preceding the EEG recording. In our previous study, 17 we assessed drug‐free patients with schizophrenia. However, because HOMO/LUMO reflects the quantum nature of organic compounds and cannot be used to simply compare the antipsychotic monotherapy group with the drug‐free group, we focused our study on antipsychotic monotherapy group.…”

“…The study was approved by the ethical committee of the Hokkaido University Graduate School of Medicine. Detailed information is described in a previous study 17 …”

“…If patterns of drowsiness appeared in the EEG recordings, subjects were aroused by acoustic stimulation. Detailed information is described in a previous study 17 …”

“…Although such abnormalities are commonly observed in patients with schizophrenia, there is growing evidence that antipsychotics can additionally modify the abnormality of EEG of patients with schizophrenia depending on their chemical structure and pharmacological profiles 15,16 . For example, atypical antipsychotic drugs tend to affect theta waves but not gamma‐band waves 17 . Because antipsychotic drugs directly bind to several specific receptors, such as gamma‐aminobutyric acid type B, N‐methyl‐ d ‐aspartate, nicotinic acetylcholine, and metabotropic glutamate receptors may be associated with EEG alterations 4,18 .…”