Transporters Transporters

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Dopamine Dopamine Amphetamine and cocaine cause Amphetamine and cocaine cause increase in dopamine. increase in dopamine. Tourette's syndrome shows increase Tourette's syndrome shows increase in dopamine transporter system in dopamine transporter system (may account for success of (may account for success of dopamine blocking therapies). dopamine blocking therapies).

 Serotonin Serotonin binding is low in Serotonin Serotonin binding is low in depression, alcoholism, cocainism, depression, alcoholism, cocainism, binge eating, and impulse control binge eating, and impulse control disorders disorders

 Metabolism Metabolism

 Nicotine Cigarette smoking inhibits MAO activity Nicotine Cigarette smoking inhibits MAO activity in brain. in brain.

 Amyloid-Deposits Can be visualized in vivo with Amyloid-Deposits Can be visualized in vivo with PET. PET.

 Pharmacology Plasma levels of cocaine peak at Pharmacology Plasma levels of cocaine peak at 2 min. 2 min.

D2 receptor occupancy lasts for several weeks

D2 receptor occupancy lasts for several weeks after discontinuation of antipsychotic after discontinuation of antipsychotic medication. medication.

D2 receptor occupancy is lower for atypical D2 receptor occupancy is lower for atypical antipsychotics than typical antipsychotics (may antipsychotics than typical antipsychotics (may account for decrease in extrapyramidal side account for decrease in extrapyramidal side effects). effects).

Low doses (10-20 mg) of selective serotonin

Low doses (10-20 mg) of selective serotonin

Alterations Associated with Medication

Alterations Associated with Medication and Drugs and Drugs

 Benzodiazepines Increased beta activity

Benzodiazepines Increased beta activity

 Clozapine (Clozaril), Olanzapine (Zyprexa), Risperidone Clozapine (Clozaril), Olanzapine (Zyprexa), Risperidone (Risperdal), Quetiapine (Seroquel) ,Aripiprazole (Abilify) (Risperdal), Quetiapine (Seroquel) ,Aripiprazole (Abilify)

No significant changes

No significant changes

 Lithium Slowing or paroxysmal activity

Lithium Slowing or paroxysmal activity

 Alcohol Decreased alpha activity; increased theta Alcohol Decreased alpha activity; increased theta activity activity

 Opioids Decreased alpha activity; increased voltage of Opioids Decreased alpha activity; increased voltage of theta and delta waves; in overdose, slow waves theta and delta waves; in overdose, slow waves

 BarbituratesIncreased beta activity; in withdrawal BarbituratesIncreased beta activity; in withdrawal states, generalized paroxysmal activity and spike states, generalized paroxysmal activity and spike discharges discharges

 MarijuanaIncreased alpha activity in frontal area of MarijuanaIncreased alpha activity in frontal area of brain; overall slow alpha activity brain; overall slow alpha activity

 CocaineSimilar to marijuanaInhalants Diffuse slowing of CocaineSimilar to marijuanaInhalants Diffuse slowing of delta and theta waves delta and theta waves

 Nicotine Increased alpha activity; in withdrawal, marked Nicotine Increased alpha activity; in withdrawal, marked

Alterations Associated with Psychiatric Alterations Associated with Psychiatric Disorders Disorders

 Panic disorder

Panic disorder

Paroxysmal EEG changes

Paroxysmal EEG changes consistent with partial seizure activity consistent with partial seizure activity during attack in one third of patients; focal during attack in one third of patients; focal slowing in about 25% of patients slowing in about 25% of patients

 CatatoniaUsually normal, but EEG CatatoniaUsually normal, but EEG indicated in new patient presenting with indicated in new patient presenting with catatonia to rule out other causes catatonia to rule out other causes

 Attention-deficit/hyperactivity disorder

Attention-deficit/hyperactivity disorder (ADHD)High prevalence (up to 60%) of (ADHD)High prevalence (up to 60%) of EEG abnormalities versus normal controls; EEG abnormalities versus normal controls; spike or spike-wave discharges spike or spike-wave discharges

 Antisocial personality disorder Increased Antisocial personality disorder Increased incidence of EEG abnormalities in those incidence of EEG abnormalities in those with aggressive behavior with aggressive behavior

 Borderline personality disorde Positive Borderline personality disorde Positive spikes: 14- and 6 per second seen in 25% spikes: 14- and 6 per second seen in 25% of patients of patients

 Chronic alcoholism Prominent slowing Chronic alcoholism Prominent slowing and periodic lateralized paroxysmal and periodic lateralized paroxysmal discharges discharges

 Alcohol withdrawal May be normal in Alcohol withdrawal May be normal in patients who are not delirious; excessive patients who are not delirious; excessive fast activity in patients with delirium fast activity in patients with delirium

 Dementia Rarely normal in advanced Dementia Rarely normal in advanced dementia; may be helpful in dementia; may be helpful in