Effects of Imipramine Hydrochloride on the EEG of children with Attention-Deficit/Hyperactivity Disorder who are non-responsive to stimulants
Although stimulant medications are the most commonly-used treatments for Attention-Deficit/Hyperactivity Disorder (AD/HD), as many as 20% of treated children do not respond clinically to stimulants. One non-stimulant medication that has been widely used when the stimulants fail is a tricyclic antidepressant, imipramine hydrochloride. This study investigated the effects of imipramine on the EEG of children with AD/HD who were poor responders to dexamphetamine and ritalin, but who showed clinical improvement on a six month trial of imipramine. An initial premedication EEG was recorded during an eyes-closed resting condition, with data Fourier transformed to provide absolute and relative power estimates for the delta, theta, alpha and beta bands. A second EEG was recorded at the end of the imipramine trial. Compared to controls, the unmedicated AD/HD children had significant global increases in absolute and relative theta, with decreased global absolute and relative alpha,increased posterior relative delta, and decreased posterior absolute beta. No change in the EEG was found as a result of administering the medication. These results suggest that good responders to imipramine have an underlying EEG abnormality different from that in children who respond to the stimulants, and that an initial pre-treatment EEG may be useful in selecting a trial medication. However, as no change in the EEG was found with imipramine, it is unlikely that the EEG will be useful in evaluating responsivity to this medication.