Pharmacopsychiatry 2000; 33(3): 109-111
DOI: 10.1055/s-2000-7976
Original Paper
Georg Thieme Verlag Stuttgart ·New York

A Comparison of the Effects of Clozapine and Olanzapine on the EEG in Patients with Schizophrenia

M. Kühn, A. Schuld, M. Haack, T. Kraus, D. Hinze-Selch, C. Lechner, T. Pollmächer
  • Max Planck Institute of Psychiatry, Munich, Germany
Further Information

Publication History

Publication Date:
31 December 2000 (online)

Clozapine is known to induce epileptic seizures and changes in EEG-patterns, including slowing and the appearance of epileptiform activity. Olanzapine, a new antipsychotic drug, shares many pharmacological and clinical properties with clozapine. However, in patients treated with olanzapine, no case of seizure induction has been reported so far, and the EEG has not been studied systematically. We examined the EEGs of patients with schizophrenia treated with either olanzapine (N = 9) or clozapine (N = 9) prior to medication and 3 to 7 weeks afterwards. Clozapine induced significant EEG slowing present in 78 % of the patients, and definite epileptiform activity appeared in 33 %. Olanzapine also induced significant EEG slowing, but less frequently (in 44 % of the patients) and less pronounced than clozapine. Olanzapine had no significant effect an epileptiform activity, but in one patient, an isolated sharp/slow-wave complex was observed. These preliminary data suggest that olanzapine induces EEG slowing to a lower extent than clozapine. Olanzapine's possible effect an the seizure threshold deserves further attention.

References

  • 1 American Psychiatric Association .Diagnostic and Statistical Manual of Mental Disorders. 4th ed., Washington, DC, American Psychiatric Press 1994
  • 2 Beasley C M, Tollefson G D, Tran P V. Safety of olanzapine.  J. Clin. Psychiat.. 1997;  58 (suppl) 13-17
  • 3 Bymaster F P, Rasmussen K, Calligaro D O, Nelson D L, DeLapp N W, Wong D T. et al . In vitro and in vivo biochemistry of olanzapine: A novel, atypical antipsychotic drug.  J. Clin. Psychiat.. 1997;  58 (suppl. 10) 28-36
  • 4 Devinsky O, Honigfeld G, Patin J. Clozapine-related seizures.  Neurology.. 1991;  41 369-371
  • 5 Freudenreich O, Weiner R D, McEvoy J P. Clozapine-induced electroencephalogram changes as a function of clozapine serum levels.  Biol. Psychiatry.. 1997;  42 132-137
  • 6 Günther W, Baghai T, Naber D, Spatz R, Hippius H. EEG alterations and seizures during treatment with clozapine. A retrospective study of 238 patients.  Pharmacopsychiatry.. 1993;  26 69-74
  • 7 Haring C, Neudorfer C, Schwitzer J, Hummer M, Saria A, Hinterhuber H. et al . EEG alterations in patients treated with clozapine in relation to plasma levels.  Psychopharmacology.. 1994;  114 97-100
  • 8 Itil T M, Shapiro D, Schneider S J, Francis I B. Computerized EEG as a predictor of drug response in treatment resistant schizophrenics.  J. Nerv. Mental Dis.. 1981;  169 629-637
  • 9 Jasper H H. The ten twenty electrode system of the International Federation.  Electroenceph. Clin. Neurophysiol.. 1958;  10 371-375
  • 10 Malow B A, Reese K B, Sato S, Bogard H J, Malhotra A K, Su T-P. et al . Spectrum of EEG abnormalities during clozapine treatment.  Electroenceph. Clin. Neurophysiol.. 1994;  91 205-211
  • 11 Meltzer H Y, Fibiger H C. Olanzapine: a new atypical antipsychotic drug.  Neuropsychopharmacology.. 1996;  14 83-85
  • 12 Pacia S V, Devinsky O. Clozapine-related seizures: Experience with 5,629 patients.  Neurology.. 1994;  44 2247-2249
  • 13 Risby E D, Epstein C M, Jewart R D, Nguyen B V, Morgan W N, Risch S C. et al . Clozapine-induced EEG abnormalities and clinical response to clozapine.  J. Neuropsychiatr. Clin. Neurosci.. 1995;  7 466-470
  • 14 Saletu B, Grünberger J. Drug profiling by computed electroencephalography and brain maps, with special consideration of sertraline and its psychometric effects.  J. Clin. Psychiatry.. 1988;  49 (Suppl. 8) 59-71
  • 15 Spatz R, Lorenzi E, Kugler J, Rüther E. Häufigkeit und Form von EEG-Anomalien bei Clozapintherapie.  Arzneimittelforschung. 1978;  28 1499-1500
  • 16 Welch J, Manschreck T, Redmond D. Clozapine-induzed seizures and EEG changes.  J. Neuropsychiat. Clin. Neurosci.. 1994;  6 250-256

M.D. Thomas Pollmächer,

Max Planck Institute of Psychiatry

Kraepelinstrasse 10

D-80804 München

Germany

Email: topo@mpipsykl.mpg.de

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