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[高剂量右旋普萘洛尔和消旋普萘洛尔治疗急性躁狂性精神病患者治疗前、治疗期间及治疗后的脑电图(作者译)]

[The EEG of patients with acute manic psychoses before, during and after treatment with high doses of d-propranolol and dl-propranolol (author's transl)].

作者信息

Coulin K, Simon O, Emrich H M, von Zerssen D

出版信息

Arch Psychiatr Nervenkr (1970). 1982;231(4):323-31. doi: 10.1007/BF00345588.

Abstract

Six manic patients, drug-free for at least 10 days, were treated with high doses (up to 3,000 mg/day, corresponding serum levels up to 1,600 ng/ml) of d-propranolol or dl-propranolol in a double-blind, placebo-controlled study. The EEG's of these patients were studied over a maximum period of 21 days. All 82 EEG's were normal, they showed neither epileptic patterns nor any other signs for hypersynchronisation, as a possible side-effect of propranolol, nor other abnormalities, due to the manic condition. Analysis by fast-fourier-transformation produced no difference between the effect of d-propranolol or dl-propranolol on EEG compared intra- and inter-hemispherically by power-spectra, cross-spectra, phase-differences and coherences. At high serum levels (more than 1,000 ng/ml) there was a corresponding increase of power and a drop in frequency of the alpha-activity, maximally--1.1 c/s, which probably depended on the serum level. This result is in agreement with the hypothesis of a direct antimanic effect of the drug and comparable to the clinical effect of lithium, which produces similar changes in EEG. A comparison of the propranolol-induced EEG changes with EEG changes usually induced by sedative drugs, contradicts the hypothesis that the antimatic properties of propranolol are caused by unspecific sedation.

摘要

在一项双盲、安慰剂对照研究中,对6名至少10天未服用药物的躁狂患者给予高剂量(高达3000毫克/天,相应血清水平高达1600纳克/毫升)的右旋普萘洛尔或消旋普萘洛尔治疗。对这些患者的脑电图进行了最长21天的研究。所有82份脑电图均正常,既未显示癫痫样波形,也未出现任何其他高同步化迹象,而高同步化可能是普萘洛尔的副作用,也未出现因躁狂状态导致的其他异常。通过快速傅里叶变换分析,比较右旋普萘洛尔或消旋普萘洛尔对脑电图半球内和半球间的影响,在功率谱、互谱、相位差和相干性方面均未发现差异。在高血清水平(超过1000纳克/毫升)时,α波活动的功率相应增加,频率下降,最大可达1.1次/秒,这可能取决于血清水平。这一结果与该药物具有直接抗躁狂作用的假设相符,且与锂的临床效果相当,锂在脑电图上也会产生类似变化。将普萘洛尔引起的脑电图变化与通常由镇静药物引起的脑电图变化进行比较,与普萘洛尔的抗躁狂特性是由非特异性镇静引起的假设相矛盾。

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