Clinical applications of pharmaco-EEG in psychiatry: the prediction of response to treatment with antipsychotics

The prediction of response to psychotropic drugs is of enormous interest in psychiatry, since absent or incomplete response to treatment may extend hospitalization time, increase direct and indirect costs of illneses and, according to the so-called neurotoxicity hypothesis, worsen the illness prognosis. In the first part of the presentation, basic assumptions of pharmaco-EEG relevant to the topic of the prediction of clinical response to antipsychotic treatment are summarized. The first step in the approach to this topic is the characterization of the quantitative EEG (QEEG) profile of the investigated drug. This is generally accomplished by assessing QEEG changes induced by a single dose of the same drug to groups of healthy subjects (test dose procedure). The prediction of patient responsiveness to a specific drug is based on the assessment of the similarity of their QEEG profile to the drug characteristic profile. In the second part of the presentation, main findings concerning QEEG changes induced by the acute administration of standard neuroleptics or novel antipsychotics in healthy subjects and in patients with schizophrenia are described. In the conclusion, achievements, limitations and future perspectives of the research field are outlined.