Effects of sertindole on EEG activity in patients with schizophrenia

Adam Kroc1, Marta Dębicka1, Aleksandra Wierzbicka1, Lidia Wołkow1,Wojciech Jernajczyk1, Adam Wichniak2

1-Department of Clinical Neurophysiology, Institute of Psychiatry and Neurology, Warsaw, Poland 2-Third Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland

Poster number: P.3.d.055 Abstract number: CG17P-1265

INTRODUCTION AND AIM:

Sertindole is an antipsychotic drug with high affinity for serotonin 5-HT2 and dopamine D2 receptors, low affinity for adrenergic α2- adrenoreceptors and histamine H1 receptors and no affinity for muscarinic cholinergic receptors and β-adrenoreceptors. This receptor binding-profile is linked with low risk of sedation as side effect during sertindole treatment. It should also be related to low potential to cause EEG slowing or other EEG alterations. Our aim was to analyze EEG recordings of patients treated with sertindole in relation to its adverse effects and clinical efficacy.

METHODS:

EEG recordings and clinical charts of 45 patients with schizophrenia (27 females, mean age 30.1 ± 8.7 years) who underwent routine EEG examination during treatment with sertindole were analyzed. As first step of the analysis the EEG recordings were reported as ‘within the normal limits’ or ‘abnormal’. Then, each abnormal recording was classified using one of the three categories (mild, moderate, severe) as in our previous study [1]. Figure 1: Clinical improvement and EEG RESULTS: abnormality in patients treated with sertindole • 32 (71%) of patients were found to have EEG 12

within normal limits. Patients with abnormal 10 EEG were classified to have either a mild- 7 8 patients or moderate abnormality- 6 patients; no patients had severe abnormality. 6 4 • Thirty six patients (80%) were found as 2 improved during treatment with sertindole. 0 Nine patients (20%) did not show any clinical Very much Much improved Minimally No change change. None of the patients clinically improved improved worsened ( Fig. 1). Normal EEG Abnormal EEG

• Thirty five out of 45 patients (78%) showed Figure 2: Most common adverse effects good tolerance of sertindole. The most EEXCESSIVE common adverse effects are shown on Fig. 2. DAYTIME INSOMNIA • Prolonged QTc calculated according to Bazett's SLEEPINESS n=3 n=4 formula was found in 5 patients, sertindole treatment had to be stopped for 2 of them due to an increase of QTc above 500 ms. EXTRAPYRA- • None of the patients showed epileptiform MIDAL discharges, focal changes or EEG asymmetry. SYMPTOMES n=3

CONCLUSION:

In comparison to treatment with many other antipsychotic drugs, patients treated with sertindole show increased slow waves EEG activity only in the minority of cases. Treatment with sertindole was also not found to be related to the presence of epileptiform discharges.

Referances: [1] Okruszek, L., Jernajczyk, W., Wierzbicka, A., Waliniowska, E., Jakubczyk, T., Jarema, M., Wichniak, A., 2014, Daytime sleepiness and EEG abnormalities in patients treated with second generation antipsychotic agents. Pharmacological Reports 66: 1077-1082.

Conflict of interest: none