A pharmaco-EEG study on antipsychotic drugs in healthy volunteers Evaluation of encephalotropic and psychotropic properties of gabapentin in man by pharmaco-EEG and psychometry. Encephalotropic and psychotropic effects of intravenous buflomedil in the elderly: double-blind, placebo-controlled pharmaco-EEG and psychometric studies. No Long-Term Effect of Behavioral Treatment on Psychotropic Drug Use for Agitation in Alzheimer's Disease Patients Potentially Inappropriate Use of Psychotropic Medications in Hospitalized Elderly Patients in France Abrupt discontinuation of psychotropic drugs during pregnancy: fear of teratogenic risk and impact of counselling. The effectiveness of a new generation of computerized drug alerts in reducing the risk of injury from drug side effects: a cluster randomized trial Controlled trial of bright light for nonseasonal major depressive disorders The impact of regular multidisciplinary team interventions on psychotropic prescribing in Swedish nursing homes. Results of a naturalistic longitudinal study of benzodiazepine and SSRI use in the treatment of generalized anxiety disorder and social phobia. Evaluating the cost-effectiveness of fall prevention programs that reduce fall-related hip fractures in older adults. Prescription patterns for psychotropic drugs in cancer patients; a large population study in the Netherlands. Psychotropic Medication Use Among Medicaid-Enrolled Children With Autism Spectrum Disorders Quantitative EEG and psychometric analyses in assessing CNS-activity of Ro 13-5057--a cerebral insufficiency improver. Comparative placebo-controlled pharmacodynamic studies with zotepine and clozapine utilizing pharmaco-EEG and psychometry. Theta Burst Stimulation of the Prefrontal Cortex: Safety and Impact on Cognition, Mood, and Resting Electroencephalogram Variations in the treatment culture of nursing homes and responses to regulations to reduce drug use. Omega-3 Polyunsaturated Fatty Acids in Prevention of Mood and Anxiety Disorders Are benzodiazepines still the medication of choice for patients with panic disorder with or without agoraphobia? One-time counselling decreases the use of benzodiazepines and related drugs among community-dwelling older persons. Drug information for the mentally ill: A randomized controlled trial. Prescribed sedative and other psychotropic medication use among clients attending alcohol and other drug treatment Improving the Quality of Pharmacotherapy in Elderly Primary Care Patients Through Medication Reviews: A Randomised Controlled Study
Rationale Both psychotropic drugs and mental disorders have typical signatures in quantitative electroencephalography ( EEG ) . Previous studies found that some psychotropic drugs had EEG effects opposite to the EEG effects of the mental disorders treated with these drugs ( key – lock principle ) . Objectives We performed a placebo-controlled pharmaco-EEG study on two conventional antipsychotics ( chlorpromazine and haloperidol ) and four atypical antipsychotics ( olanzapine , perospirone , quetiapine , and risperidone ) in healthy volunteers . We investigated differences between conventional and atypical drug effects and whether the drug effects were compatible with the key – lock principle . Methods Fourteen subjects underwent seven EEG recording sessions , one for each drug ( dosage equivalent of 1 mg haloperidol )  . In a time-domain analysis , we quantified the EEG by identifying clusters of transiently stable EEG topographies ( microstates ) . Frequency-domain analysis used absolute power across electrodes and the location of the center of gravity ( centroid ) of the spatial distribution of power in different frequency b and s. Results Perospirone increased duration of a microstate class typically shortened in schizophrenics . Haloperidol  increased mean microstate duration of all classes , increased alpha 1 and beta 1 power , and tended to shift the beta 1 centroid posterior . Quetiapine decreased alpha 1 power and shifted the centroid anterior in both alpha b and s. Olanzapine shifted the centroid anterior in alpha 2 and beta 1 . Conclusions The increased microstate duration under perospirone and haloperidol was opposite to effects previously reported in schizophrenic patients , suggesting a key – lock mechanism . The opposite centroid changes induced by olanzapine and quetiapine compared to haloperidol might characterize the difference between conventional and atypical antipsychotics In a double-blind , placebo-controlled study the encephalotropic and psychotropic properties of gabapentin - a new gaba-analogue with anticonvulsant and antispastic properties penetrating the blood brain barrier easily - were studied in 10 normal subjects by means of quantitative pharmaco-EEG and psychometric analyses . They received r and omized and in weekly intervals single oral doses of 50 mg , 100 mg , 200 mg and 400 mg gabapentin as well as placebo .  EEG recordings and evaluation of pulse , blood pressure and side effects were carried out after 0 , 1 , 2 , 4 , 6 and 8 hours ; psychometric tests were done at the same times except for the first hour . Computer-assisted spectral analysis of the EEG showed moderate though significant central effects of gabapentine in doses of 200 - 400 mg as compared with placebo , which were maximally pronounced in the 2nd hour post drug . These alterations were generally characterized by an attenuation of total power , augmentation of delta and theta activity and a decrease of alpha activity indicating CNS-inhibitory properties . Only at the late hours did the type of changes shift towards a vigilance-promoting one . Beta activity showed alternating changes . Psychometric and psychophysiological evaluations demonstrated subtle psychotropic effects as compared with placebo characterized mostly by an improvement in concentration , numerical memory , complex reaction and performance in the alphabetical reaction test while performance variability increased as well . Subjectively experienced well-being changed dose-dependently . CFF decreased after 100 mg as did pupil size after 50 - 200 mg . Evaluation of pulse , blood pressure and side effects demonstrated good tolerability of the drug In a double-blind placebo-controlled study , the encephalotropic and psychotropic properties of intravenously administered buflomedil -- a new vasoactive drug -- were studied in 10 elderly volunteers in their 60s by means of quantitative EEG and psychometric analyses . At weekly intervals the patients received r and omized ( latin square design ) , single , intravenous doses of placebo , 50 mg , 100 mg and 200 mg buflomedil as well as 2000 mg piracetam as reference substance . EEG recordings and the monitoring of blood pressure , heart rate and side-effects were carried out at hours 0 , 1 , 2 , 4 , 6 and 8 . Psychometric tests were performed at hours 0 , 2 , 4 , 6 and 8 . Computer-assisted spectral analysis of the EEG demonstrated that buflomedil exerted a significant effect on the central nervous system ( CNS ) as compared with placebo , characterized by a decrease of delta and theta , increase of alpha and alpha-adjacent beta activity as well as by an acceleration of the centroid of the alpha activity and also of the total activity . 2 g piracetam induced the same type of changes only at the end of the recording day . These quantitative EEG changes have been previously observed after several antihypoxidotic/nootropic drugs and indicate an improvement in vigilance in the sense of Head . Treatment-efficacy calculations demonstrated that 200 mg buflomedil was the most CNS-effective substance followed by 100 mg and 50 mg buflomedil and 2 g piracetam .  Time-efficacy calculations showed that the encephalotropic effects were already marked in the 1st hour after i.v . application , decreased to a low in the 4th hour and subsequently increased again to reach a maximum in the 8th hour . In contrast , 2 g piracetam induced CNS changes which increased from the 1st throughout the 6th hour to show only a slight decline thereafter . The hysteresis between pharmacodynamic and pharmacokinetic findings is discussed . Psychometric investigations demonstrated that after 50 mg buflomedil i.v . there was a significant improvement as compared with placebo in cognitive function based on the Pauli test as well as an increase in correct reactions in the alphabetical reaction test . Doses of 100 mg buflomedil also produced an improvement in the Pauli test , attenuated errors in the reaction time task , improved complex reaction on the Vinnese Determinationsgerät , increased CFF but also errors in the concentration test . ( ABSTRACT TRUNCATED AT 400 WORDS To determine if teaching caregivers behavior management techniques ( BMTs ) reduces long-term psychotropic use in Alzheimer 's disease ( AD ) patients , we examined 12-month follow-up data from a 4-month r and omized study com paring placebo , BMTs , trazodone , and haloperidol for the treatment of  agitated behaviors in persons with AD . After 4 months , treatment was allowed with any agent . Between 42.8 % and 51 % of AD patients received additional psy chotropics between 4 and 12 months . The relative risk of being prescribed any psychotropic drug after the 4-month trial was at or about 1.0 for subjects in each drug arm or placebo arm versus BMTs . We concluded that teaching  caregivers BMTs did not diminish long-term prescription of psychotropic drugs . ( J Geriatr Psychiatry Neurol 2002 ; 15:95 - 98 ) Abstract Background : In France , there is evidence to suggest that 50 % of elderly individuals are prescribed psychotropic medications . However , it is known that use of these agents increases the risk of falls , fractures and delirium in older people . Objective : To study the consumption of ‘ potentially inappropriate medication ’ ( PIM ) among patients aged ≥75 years , paying particular attention to psychotropic drugs and the factors influencing the use of ‘ potentially inappropriate psychotropics ’ ( PIPs ) . Method : This was a cross-sectional analysis of a prospect i ve multicentre cohort of 1306 hospitalized French patients aged ≥75 years ( the SAFEs [ Sujet Âgé Fragile : Évaluation et suivi ( Frail Elderly Subjects : Evaluation and follow-up ) ] cohort ) . The present analysis involved the 1176 patients for whom there was information on the usual treatments being taken in the 2 weeks before hospitalization . The drugs were coded according to the Anatomical Therapeutic Chemical classification ; the Beers list as up date d in 2003 defined which medications were considered PIPs . St and ardized geriatric assessment variables were recorded on inclusion in the study . Logistic regression analysis was performed to identify factors linked to use of psychotropics and PIPs . Results : The mean number of drugs taken was 5.7 ± 2.9 per patient . Twenty-eight percent of patients took at least one PIM . The number of patients who had taken at least one psychotropic drug  in the 2 weeks before hospitalization ( mean 1.6 ± 0.9 psychotropics per patient ) was 589 ( 50.1 % ) . More than half of both the 510 patients with a depressive syndrome and the 543 patients affected by dementia were treated with psychotropics . Multivariate analysis showed that prescription of psychotropics was linked to the presence of a dementia syndrome ( odds ratio [ OR ] = 1.4 ; 95 % CI 1.1 , 1.9 ; p = 0.03 ) , the presence of a depressive syndrome ( OR = 1.7 ; 95 % CI 1.3 , 2.1 ; p < 0.001 ) , living in an institution ( OR = 2.2 ; 95 % CI 1.5 , 3.4 ; p < 0.001 ) , use of more than five drugs ( OR = 3.2 ; 95 % CI 2.5 , 4.2 ; p < 0.001 ) and Charlson ’s co-morbidity score > 1 ( OR = 0.6 ; 95 % CI 0.5 , 0.8 ; p = 0.001 ) . Nineteen percent of all psychotropics prescribed were PIPs . Of these PIPs , 66.5 % were anxiolytics , 28.4 % were antidepressants and 5.1 % were  antipsychotics  . Use of PIPs in the multivariate analysis was associated only with consumption of more than five drugs ( OR = 1.7 ; 95 % CI 1.1 , 2.5 ; p = 0.01 ) . Conclusion : PIM use is common among hospitalized older adults in France . The most important determinant of risk of receiving a psychotropic medication or a PIP was the number of drugs being taken . The elderly , who have multiple comorbidities , complex chronic conditions and are usually receiving polypharmacy , are at increased risk for adverse drug events . These adverse events are often linked to problems that could be preventable such as delirium , depression and falls . Regular review of prescriptions would help optimize prescription of psychotropics in the elderly . The Beers list is a good tool for evaluating PIMs but is too restrictive with respect to psychotropics ; in the latter respect , the list could usefully be widened OBJECTIVE To assess the consequences to mother and baby of abruptly discontinuing antidepressant or benzodiazepine medication during pregnancy and to assess the impact of our counselling . PARTICIPANTS All women who consulted the Motherisk Program between November 1996 and December 1997 and who stopped taking antidepressant or benzodiazepine medication when pregnancy was confirmed agreed to participate in the study . DESIGN AND INTERVENTIONS Subjects were interviewed , received counselling , and completed a question naire 1 month after their initial call and after the birth of their baby . RESULTS Of 36 women who completed the study , 34 discontinued their medication abruptly for fear of harming the fetus , 28 on the advice of their physician ; 26 ( 70.3 % ) women reported physical and psychological adverse effects , 11 reported psychological effects only , and 11 reported suicidal ideation ( 4 were admitted to hospital ) . After counselling , 22 of 36 ( 61.1 % ) women resumed taking their medication , and 4 found that they no longer required it . One woman had a therapeutic abortion and 2 experienced spontaneous abortions ; there were therefore 35 healthy babies ( including 2 sets of twins ) born to 33 women ; 14 of 21 mothers breast-fed their babies while taking their psychotropic medication , with no adverse effects reported . CONCLUSIONS When assessing the risks and benefits of taking psychotropic medication during pregnancy , women and their physicians should be aware that the abrupt discontinuation of psychotropic drugs can lead to serious adverse effects . Counselling is effective in reassuring women to adhere to therapy Context Computerized drug alerts for psychotropic drugs are expected to reduce fall-related injuries in older adults . However , physicians over-ride most alerts because they believe the benefit of the drugs exceeds the risk . Objective To determine whether computerized prescribing decision support with patient-specific risk estimates would increase physician response to psychotropic drug alerts and reduce injury risk in older people . Design Cluster r and omized controlled trial of 81 family physicians and 5628 of their patients aged 65 and older who were prescribed psychotropic medication .  Intervention Intervention physicians received information about patient-specific risk of injury  computed at the time of each visit using statistical models of non-modifiable risk factors and psychotropic drug doses . Risk thermometers presented changes in absolute and relative risk with each change in drug treatment . Control physicians received commercial drug alerts . Main outcome measures Injury risk at the end of follow-up based on psychotropic drug doses and non-modifiable risk factors . Electronic health records and provincial insurance administrative data were used to measure outcomes . Results Mean patient age was 75.2 years .  Baseline risk of injury was 3.94 per 100 patients per year . Intermediate-acting benzodiazepines ( 56.2 % ) were the most common psychotropic drug . Intervention physicians review ed therapy in 83.3 % of visits and modified therapy in 24.6 % . The intervention reduced the risk of injury by 1.7 injuries per 1000 patients ( 95 % CI 0.2/1000 to 3.2/1000 ; p=0.02 ) . The effect of the intervention was greater for patients with higher baseline risks of injury ( p<0.03 ) . Conclusion Patient-specific risk estimates provide an effective method of reducing the risk of injury for high-risk older people . Trial registration number clinical trials.gov Identifier : NCT00818285 Psychotropic drug-free hospitalized veterans with nonseasonal major depressive disorders or depressed forms of bipolar disorder were treated with light for 1 week . Twenty-five patients were r and omly assigned to bright white light treatment ( 2000 - 3000 lux ) , and 26 patients were r and omized to dim red light placebo control treatment . Unlike those treated with dim red light , those treated with bright white light showed declines in three measures of depression during treatment . Partial relapse appeared within 2 days . A global depression score showed a statistically significant ( p = 0.02 ) difference favoring bright white light treatment . Two bright-light-treated patients became mildly hypomanic , but side effects were mild . Improvement was not correlated with patient expectations ; indeed , patients expected somewhat greater benefit from the placebo . Patients treated in summer responded as well as those treated in winter . Baseline electroencephalogram ( EEG ) sleep stage data ( e.g. , rapid eye movement ; REM latency ) did not predict treatment responses . These 1-week treatment results suggest that bright light might produce benefits for patients with nonseasonal depression .  Bright light should not be recommended for routine clinical application before additional assessment s with longer treatment duration s are done OBJECTIVE To evaluate the impact of regular multidisciplinary team interventions on the quantity and quality of psychotropic drug prescribing in Swedish nursing homes . DESIGN A r and omized controlled trial . SETTING A sample of 33 nursing homes : 15 experimental homes and 18 control homes representing 5 % of all Swedish nursing homes . PARTICIPANTS The sample consisted of 1854 long-term care residents with an average age of 83 years . Seventy percent of the residents were women , and 42 % had a documented diagnosis of dementia . An additional 5 % had a psychotic disorder , and 7 % had a diagnosis of depression . INTERVENTION Experimental homes participated in an outreach program that was design ed to influence drug use through improved teamwork among physicians , pharmacists , nurses , and nurses ' assistants . Multidisciplinary team meetings were held on a regular basis throughout the 12-month study period . MEASUREMENTS Lists of each resident 's prescriptions were collected 1 month before and 1 month after the 12-month intervention . Measures included the proportion of residents with any psychotropic drug , polymedicine , and therapeutic duplication and proportion of residents with nonrecommended and acceptable drugs in each psychotropic drug class , as defined by current Swedish guidelines . RESULTS Baseline results show extensive psychotropic drug prescribing , with the most commonly prescribed drugs being hypnotics ( 40 % ) , anxiolytics ( 40 % ) , and antipsychotics ( 38 % ) . After 12 months of team meetings in the experimental homes , there was a significant decrease in the prescribing of psychotics ( -19 % ) , benzodiazepine hypnotics ( -37 % ) , and antidepressants ( -59 % ) . Orders for more acceptable antidepressants also increased in the experimental homes . In the control homes there was increased use of acceptable antidepressants , but there were no significant reductions in other drug classes . CONCLUSIONS There is excessive prescription of psychotropic drugs in Swedish nursing homes . Improved teamwork among caregivers can improve prescribing as defined by clinical guidelines The past decade has brought major new developments in the psychopharmacologic management of generalized anxiety disorder and social phobia . We examined medication-prescribing patterns for the treatment of these anxiety disorders for 12 years to assess changes in patients ' anti-anxiety psychotropic medication usage during that period of evolving practice guidelines . We examined psychotropic medication use in 305 patients with generalized anxiety disorder and 232 with social phobia enrolled in the Harvard/Brown Anxiety Disorders Research Project ( HARP ) , a prospect i ve , longitudinal study of anxiety disorders .  Psychotropic treatment patterns seem to have remained relatively stable over 12 years with benzodiazepines the medications most commonly used for both generalized anxiety disorder and social phobia . Comparatively , selective serotonin reuptake inhibitor ( SSRI ) and venlafaxine usage as st and -alone medications for these disorders remained low throughout the follow-up period . At the 12-year follow-up , 24 % of patients with generalized anxiety disorder and 30 % of patients with social phobia were utilizing neither an  SSRI/selective norepinephrine reuptake inhibitor ( SNRI ) nor a benzodiazepine . Treatment recommendations for use of SSRIs and venlafaxine in the management of generalized anxiety disorder and social phobia initially promulgated in 1998 had a modest impact on changes in psychopharmacologic practice 4 - 5 years later . Difficulties in the implementation of treatment guidelines are discussed OBJECTIVES To model the incremental cost-utility of seven interventions reported as effective for preventing falls in older adults . DESIGN Mathematical epidemiological model populated by data based on direct clinical experience and a critical review of the literature . SETTING Model represents population level interventions . PARTICIPANTS No human subjects were involved in the study . MEASUREMENS : The last Cochrane data base review and meta-analyses of r and omized controlled trials categorized effective fall-prevention interventions into seven groups : medical management ( withdrawal ) of psychotropics , group tai chi , vitamin D supplementation , muscle and balance exercises , home modifications , multifactorial individualized programs for all elderly people , and multifactorial individualized treatments for high-risk frail elderly people . Fall-related hip fracture incidence was obtained from the literature . Salary figures for health professionals were based on Bureau of Labor Statistics data . Using an integrated healthcare system perspective , healthcare costs were estimated based on practice and studies on falls in older adults . Base case incremental cost utility ratios were calculated , and probabilistic sensitivity analyses were conducted . RESULTS Medical management of psychotropics and group tai chi were the least-costly , most-effective options , but they were also the least studied . Excluding these interventions , the least-expensive , most-effective options are  vitamin D supplementation and home modifications . Vitamin D supplementation costs less than home modifications , but home modifications cost only $ 14,794/ quality -adjusted life year ( QALY ) gained more than vitamin D. In probabilistic sensitivity analyses excluding management of psychotropics and tai chi , home modification is most likely to have the highest economic benefit when QALYs are valued at $ 50,000 or $ 100,000 . CONCLUSION Of single interventions studied , management of psychotropics and tai chi reduces costs the most . Of more-studied interventions , home modifications provide the best value . These results must be interpreted in the context of the multifactorial nature of falls BACKGROUND Psychotropic drugs are commonly prescribed for various psychological complaints in cancer patients . We aim to examine the prescription pattern in cancer patients of three common  psychotropic drugs : benzodiazepine , antidepressant and antipsychotic . METHODS This is a retrospective case-control study . Data were extracted from the Agis Health Data base . This insurance data base contains the healthcare consumption of 1.3 million inhabitants of the Netherl and s. We analyzed the use of psychotropics in cancer patients and an equally sized r and omly selected control group of noncancer patients from 2006 to 2008 .  Odds ratio ( OR ) were adjusted for age , gender , immigrant status , neighborhood socio-economic status , and premorbid medical condition . Additionally , the numbers of new user in the 3 months after cancer was diagnosed and in the 3 months before death were compared . RESULTS A total of 113 887 cancer patients and 121 395 control subjects were included . Cancer patients were significantly more often prescribed  psychotropic drugs  ( adjusted OR : benzodiazepines = 1.70 , CI = 1.67 - 1.74 ; antidepressants = 1.38 , CI = 1.34 - 1.42 ; and antipsychotics = 1.70 , CI = 1.62 - 1.77 ) . Lower socio-economic status , immigrant , and premorbid chronic medical conditions were significantly associated with higher risk of psychotropic use . Odds for a new prescription for all three psychotropic drugs  were significantly less in the first 3 months after cancer diagnosis than the 3 months before death ( benzodiazepine , OR = 0.673 , CI = 0.647 - 0.705 ; antidepressant , OR = 0.592 , CI = 0.544 - 0.644 ; antipsychotic , OR = 0.177 , CI = 0.165 - 0.190 ) CONCLUSIONS : Psychotropic drug prescription is common in cancer patients , starts soon after diagnosis , and increases in the terminal stage . Prescription rates were significantly higher in patients from lower socio-economic group , immigrants , or with premorbid chronic medical condition OBJECTIVE . The objective of this study was to provide national estimates of psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders and to examine child and health system characteristics associated with psychotropic medication use . METHODS . This cross-sectional study used Medicaid cl aims for calendar year 2001 from all 50 states and Washington , DC , to examine 60641 children with an autism spectrum disorder diagnosis .  Logistic regression with r and om effects was used to examine the child , county , and state factors associated with psychotropic medication use . RESULTS . Of the sample , 56 % used at least 1 psychotropic medication , 20 % of whom were prescribed ≥3 medications concurrently . Use was common even in children aged 0 to 2 years ( 18 % ) and 3 to 5 years ( 32 % ) . Neuroleptic drugs were the most common psychotropic class ( 31 % ) , followed by antidepressants ( 25 % ) and stimulants ( 22 % ) . In adjusted analyses , male , older , and white children ; those who were in foster care or in the Medicaid disability category ; those who received additional psychiatric diagnoses ; and those who used more autism spectrum disorder services were more likely to have  used psychotropic drugs  . Children who had a diagnosis of autistic disorder or who lived in counties with a lower percentage of white residents or greater urban density were less likely to use such medications . CONCLUSIONS . Psychotropic medication use is common among even very young children with autism spectrum disorders . Factors unrelated to clinical presentation seem highly associated with prescribing practice s. Given the limited evidence base , there is an urgent need to assess the risks , benefits , and costs of medication use and underst and the local and national policies that affect medication use In a double-blind , placebo-controlled cross-over study , the encephalotropic , psychotropic and pharmacodynamic properties of Ro 13 - 5057/001 , a new 2-pyrrolidinone derivative , were investigated in 10 geriatric subjects . They received in r and omized order at weekly intervals , single oral doses of placebo , 250 mg , 500 mg and 1000 mg Ro 13 - 5057 , as well as 2000 mg pirazetam as reference drug . EEG recordings , psychometric testing and evaluation of blood pressure , pulse rate and side effects were carried out at the hours 0 , 2 , 4 , 6 , 8 and 24 . Power spectral density analysis of the EEG demonstrated Ro 13 - 5057 to be an encephalotropic drug , as statistically significant CNS changes occurred in comparison to placebo , which were characterized by a decrease of delta activity , increase of alpha activity and slow beta activity and acceleration of dominant frequency . The reference drug 2000 mg pirazetam induced similar changes . Such alterations were previously described by us as typical for certain antihypoxidotic/nootropic drugs and are indicative of improvement in vigilance . Psychometric data confirmed this interpretation of neurophysiological alterations as shortening of reaction time , acceleration of tapping speed , CNS activation as measured by the Archimedean spiral , improvement in mood as well as improvement in qualitative but deterioration of quantitative aspects of attention were observed at various times after the active substances as compared with placebo . Regarding time-efficacy , the peak effect in CNS changes was noted in the 2nd hour after Ro 13 - 5057 , but interestingly there were also alterations as late as 24 hours after oral administration . Dose-efficacy curves suggested 1000 mg Ro 13 - 5057 as the most effective compound of the study . The lack of side effects and clinical ly relevant changes in blood pressure and pulse rate indicates that the drug is well tolerated in man In a double-blind , placebo-controlled study the encephalotropic and psychotropic properties of zotepine - a new tricyclic dibenzothiepine with antidopaminergic , adrenolytic and antiserotoninergic properties - were investigated utilizing quantitative EEG , psychometric and psychophysiological tests as well as clinical observations . Fifteen normal volunteers received r and omized ( latin square design ) and at weekly intervals single oral doses of placebo , 25 mg , 50 mg and 100 mg zotepine as well as 50 mg clozapine as reference compound . Plasma samplings for blood levels , EEG recordings , and evaluation of blood pressure , pulse rate and side-effects were carried out at the hours 0 , 1 , 2 , 4 , 6 and 8 , while psychometric data were recorded at the same time except the first hour . Computer-assisted spectral analysis of the EEG demonstrated after all three doses significant changes as compared with placebo characterized by an augmentation of delta and theta activity , decreased of alpha and beta activity , slowing of the centroid of the total activity and alpha activity , and decrease of the dominant frequency and its absolute and relative power . Such changes are typical for low-potency basic neuroleptics of the sedative type such as chlorpromazine . Clozapine also augmented slow activities , decreased alpha activity , the dominant frequency and the alpha centroid , but induced in contrast to zotepine a concomitant increase of fast beta activity , acceleration of the beta centroid and no slowing of the dominant frequency , while the total power was significantly attenuated . These findings confirm earlier reports about the pharmaco-EEG profile of clozapine , which has a resemblance to profiles of anticholinergic antidepressants of the amitriptyline type . Psychometric tests demonstrated after the higher doses of zotepine and clozapine a deterioration of noopsychic and thymospsychic functions which was more pronounced after the reference compound than after zotepine . The lowest dose of zotepine , 25 mg , even produced an improvement in numerical memory and complex reaction . CFF , skin conductance , pupillary diameter and pupillary response measurements decreased after both compounds . Dose-efficacy calculations showed 100 mg zotepine and clozapine to be the most CNS-effective compounds , followed by 50 mg and 25 mg zotepine , while placebo induced the least changes . Time-efficacy calculations showed neurophysiological and behavioral peak effects after zotepine at the 4th and 6th hour , as compared with the 2nd and 4th hour after clozapine . Pulse rate increased with both compounds ; blood pressure decreased after clozapine but remained unchanged after zotepine . ( ABSTRACT TRUNCATED AT 400 WORDS BACKGROUND Because st and ard repetitive transcranial magnetic stimulation ( rTMS ) protocol s exhibit post-stimulus effects of short duration , novel protocol s such as theta burst stimulation ( TBS ) , are promising approaches to enhance the effectiveness of rTMS .  However , little is known about the side effect profile of such protocol s. Thus , the present study explores whether TBS is safe particularly in terms of effects on cognition , mood , and electroencephalogram ( EEG ) measures in healthy subjects . METHODS Twenty-four healthy volunteers participated in 2 r and omized , placebo-controlled , cross-over experiments and underwent continuous TBS ( cTBS ) , intermittent TBS ( iTBS ) , and shamTBS either over the left dorsolateral prefrontal cortex ( DLPFC , n = 12 ) or the medial prefrontal cortices ( mPFC , n = 12 ) . Clinical side effects , performance in a neuropsychological battery , mood changes , and resting EEG were recorded . RESULTS Neither a seizure nor epileptiform EEG activity was observed . The most prominent side effect was the occurrence of vagal reactions during TBS ; otherwise no serious side effects were found . St and ardized low-resolution brain electromagnetic tomography showed current density changes in the alpha2 b and after iTBS of the DLPFC , which remained detectable up to 50 min after stimulation . The few changes in neuropsychological performance were concordant with stimulation site . No impact on mood was detected . CONCLUSIONS Although TBS protocol s of the human prefrontal cortex seem to be safe in healthy subjects , future studies need to address the occurrence of vagal reactions . Excitatory and inhibitory properties of motor cortex TBS might not be transferable to prefrontal sites , and the action of specific TBS protocol s needs to be further investigated prior to clinical application OBJECTIVE The study examined the relationship between treatment cultures of nursing homes and their responses to regulations to reduce use of psychotropic drugs m and ated by the 1987 Omnibus Budget Reconciliation ACT : The authors hypothesized that reduction in use of antipsychotic drugs was more likely to occur in homes with a resident-centered culture emphasizing psychosocial care , avoidance of psychotropic drugs , pharmacist feedback , and involvement of mental health workers . The authors also predicted greater reductions in drug use in facilities with a less severe case mix and better capacity for change . METHODS Data were collected in a stratified r and om sample of 16 skilled nursing facilities in Wisconsin . Participants included 1,181 residents in the baseline study and 1,650 residents in the follow-up study . Treatment culture was measured with a question naire for assessing nurses ' beliefs and philosophies of care and their interactions with pharmacists and mental health workers . RESULTS No significant change was observed in the use of benzodiazepines , antidepressants , or polymedicine  ( two or more psychotropic medications ) . However , use of antipsychotic drugs  decreased significantly , from 24 percent to 16 percent . The change in use varied dramatically across facilities , from an 85 percent reduction to a 19 percent increase . Findings also revealed significant variability in treatment cultures . Greater reductions in use of antipsychotic drugs  were found in facilities with a resident-centered culture , a less severe case mix , and a higher nurse-to-resident staffing ratio . CONCLUSIONS Future policy and quality improvement efforts must address treatment cultures , staffing , and other organizational barriers to nursing home reform Psychiatric disorders in general , and major depression and anxiety disorders in particular , account for a large burden of disability , morbidity and premature mortality worldwide . Omega-3 polyunsaturated fatty acids ( PUFAs ) have a range of neurobiological activities in modulation of neurotransmitters , anti-inflammation , anti-oxidation and neuroplasticity , which could contribute to psychotropic effects . Here we review ed recent research on the benefits of omega-3 PUFA supplements in prevention against  major depression , bipolar disorders , interferon-α-induced depression patients with chronic hepatitis C viral infection , and posttraumatic stress disorder . The biological mechanisms underlying omega-3 PUFAs ’ psychotropic effects are proposed and review ed . Nutrition is a modifiable environmental factor that might be important in prevention medicine , which have been applied for many years in the secondary prevention of heart disease with omega-3 PUFAs . This review extends the notion that nutrition in psychiatry is a modifiable environmental factor and calls for more research es on prospect i ve clinical studies to justify the preventive application of omega-3 PUFAs in daily practice OBJECTIVE Recently , pharmacological treatment guidelines for panic disorder have changed as newer treatment options have become available . The authors examined how the use of psychotropic drugs has shifted over the course of 10 years to determine if prescribing patterns have changed to reflect these revised treatment guidelines . METHOD A total of 443 patients with panic disorder were enrolled in the Harvard/Brown Anxiety Research Project , a prospect i ve longitudinal study of anxiety disorders . These patients were interviewed over the course of 10 years to examine their use of psychotropic medications . RESULTS Despite efforts aim ed at increasing the use of selective serotonin reuptake inhibitors ( SSRIs ) in patients with panic disorder ( e.g. , APA 's practice guideline for panic disorder , Food and Drug Administration approval of particular SSRIs for the treatment of panic disorder ) , only a modest increase in their use was found . Treatment patterns for psychotropic drugs  appear to have remained stable over the past decade , with benzodiazepines being the most commonly used medication for panic disorder . In comparison , SSRI use throughout the follow-up period has remained low . Patients using an SSRI did not have a more favorable clinical course than those using a benzodiazepine , nor were there significantly better rates of remission in patients using SSRIs and benzodiazepines concomitantly . CONCLUSIONS These results highlight a gap between pharmacological treatment guidelines and actual delivery of care in that recommendations to use SSRIs to treat panic disorder are not being followed . Factors potentially associated with promoting and ignoring treatment recommendations are discussed BACKGROUND evidence about possibilities to help older persons to withdraw the long-term use of benzodiazepines ( BZD ) is scarce . Effective and practicable methods are needed . OBJECTIVE the study aim ed to assess the persistence of one-time counselling by a geriatrician to reduce psychotropic drugs , especially BZD and related drugs ( RD ) . DESIGN a prospect i ve r and omised controlled trial with a 12-month follow-up was conducted . SUBJECTS five hundred ninety-one community-dwelling people aged 65 or older participated in the study . METHODS instructions to withdraw , reduce or change psychotropic drugs were given to the intervention group . A 1-h lecture about these drugs and their adverse effects was given later on . No changes in the drug therapy were suggested for the controls . RESULTS the number of regular users of BZD and RD decreased by 35 % ( 12/34 ) ( odds ratios ( OR ) = 0.61 , 95 % confidence interval ( 95 % CI ) 0.44 - 0.86 ) in the intervention group while it increased by 4 % ( 2/46 ) ( OR = 1.05 , 95 % CI 0.81 - 1.36 ) in the controls ( P = 0.012 ) . No significant changes in the users of other types of psychotropics were found . CONCLUSION one-time counselling of psychotropics and other fall-risk-increasing drugs by a geriatrician followed with a 1-h lecture about adverse effects of these drugs had positive effects in decreasing the number of regular users of BZD and RD , and these effects persisted for the total 12-month intervention period Drugs play a significant role in maintaining the health of the mentally ill Lack of information is known to be one of the chief reasons for patients ' failure to adhere to prescribed regimens . This study was design ed to evaluate the impact of drug information leaflets for mentally ill patients on knowledge and satisfaction concerning psychotropic drug therapy . We conducted a r and omized controlled trial of 249 adult general psychiatry patients ( 124 in patients and 125 community patients ) , half assigned to the invervention ( i.e. ,  patient information leaflets ;  these patients also received the usual information ) ( n = 120 ) and half receiving the usual information only ( n = 129 ) . The assessment s were made using a semi-structured question naire . The mean total knowledge score was significantly higher with intervention in both acute and community patients . Analysis of individual aspects of knowledge showed a marked lack of knowledge in the areas of side-effects and pre caution s , which improved significantly with intervention . Patients in the community showed a greater awareness of their drug therapy than did in patients . Improvement in knowledge was evident in all diagnostic groups . There was no significant relationship with age , sex , level of education and number of drugs . Overall , 60 % of controls and 79 % of leaflet patients were satisfied with their drug information . Patient information leaflets provided a useful source of reference for the patients and the carers INTRODUCTION AND AIMS Prescribed psychotropic medications contribute to overdose mortality among people with alcohol and other drug ( AOD ) disorders . We report on prescribed psychotropic medication use among AOD treatment service attendees , focusing on sedative drugs . DESIGN AND METHODS Prospect i ve multi-site naturalistic outcome study in residential and outpatient AOD treatment facilities in Victoria and Western Australia . A convenience sample of 480 people ( 57 % male ; mean age 36.1 ) entering treatment were surveyed , of whom 313 ( 65 % ) were followed up by telephone interview after a median of 377 days . Participants ' prescribed psychotropic medication use was ascertained by self-report at baseline and follow-up . RESULTS At baseline , 41 % of participants reported prescribed sedative medication ( benzodiazepine , zopiclone or zolpidem ) use within the past month , including prescriptions to treat withdrawal symptoms . At follow-up , the cohort reported a reduced rate of past month prescribed sedative use ( 23 % ; P < 0.001 ) and this rate did not significantly differ between those who continued to use their primary drug of concern and those who were abstinent at follow-up ( P = 0.08 ) . Among those with opioids as their primary drug of concern , one-third were still being prescribed a sedative  at follow-up ( P > 0.99 for change from baseline ) . At baseline , 40 % of participants were prescribed an  antidepressant  and 13 % an  antipsychotic medication  , which remained similar at follow-up ( 45 % and 13 % , respectively ) . DISCUSSION AND CONCLUSIONS The high level of prescribed sedative drug use reported by people receiving AOD treatment is a serious public health concern given the increasing incidence of drug overdose deaths in Australia Background Polypharmacy in the Swedish elderly population is currently a prioritised area of research with a focus on reducing the use of potentially inappropriate medications ( PIMs ) . Multi-professional interventions have previously been tested for their ability to improve drug therapy in frail elderly patients . Objective This study aim ed to assess a structured model for pharmacist-led medication review s in primary health care in southern Sweden and to measure its effects on numbers of patients with PIMs ( using the definition of the Swedish National Board of Health and Welfare ) using ≥10 drugs and using ≥3 psychotropics . Methods This study was a r and omised controlled clinical trial performed in a group of patients aged ≥75 years and living in nursing homes or the community and receiving municipal health care .  Medication review s were performed by trained clinical pharmacists based on nurse-initiated symptom assessment s with team-based or distance feedback to the physician . Data were collected from the patients ’ electronic medication lists and medical records at baseline and 2 months after the medication review . Results A total of 369 patients were included : 182 in the intervention group and 187 in the control group . One-third of the patients in both groups had at least one PIM at baseline . Two months after the medication review s , the number of intervention group patients with at least one PIM and the number of intervention group patients using ten or more drugs had decreased ( p = 0.007 and p = 0.001 , respectively ) , while there were no statistically significant changes in the control patients . No changes were seen in the number of patients using three or more psychotropic drugs , although the dosages of these drugs tended to decrease . Drug-related problems ( DRPs ) were identified in 93 % of the 182 patients in the intervention group . In total , there were 431 DRPs in the intervention group ( a mean of 2.5 DRPs per patient , range 0–9 , SD 1.5 at 95 % CI ) and 16 % of the DRPs were related to PIMs . Conclusions Medication review s involving pharmacists in primary health care appear to be a feasible method to reduce the number of patients with PIMs , thus improving the quality of pharmacotherapy in elderly patients
RESULTS Following an extensive review of selected studies from the 201 articles , the studies indicate that each of the psychotropic medications review ed impact alpha , beta , delta and theta waves independently and differently from each other .
Additionally , certain medications , particularly haloperidol and valproic acid , have dissimilar results exemplified in all waveforms .
OBJECTIVES It is known that psychotropic medications have an impact on the readings found in Electroencephalogram ( EEG ) .
In the field of psychiatry , there are several psychotropics utilized by clinicians .
This review seeks to investigate all the available data for psychotropic drugs and their impact on EEG changes .