LIBRIUM THERAPY AND ELECTROENCEPHALOGRAPHIC CORRELATES

Abstract

Librium (chlordiazepoxide) therapy, in a moderate dosage schedule of 30 to 40 mg. per day in divided doses, was used in a series of 75 psychiatric patients, including a group of severe behavior problem adolescents. A total of 159 eegs was obtained; in 35 of the 41 patients with abnormal recordings, serial studies were done before, during and after Librium therapy. Of this group of 35, 25 showed eeg improvement, 22 improved clinically, and 17 improved both clinically and in the eeg. Of the 34 patients with normal eegs, 23 had a satisfactory clinical response to Librium therapy. All patients with an anxiety component in their illness improved clinically, whether the eeg was normal or abnormal, and whether or not it improved. Five of eight patients with anxiety and abnormal eeg''s showed both clinical and eeg improvement. The Librium effect, low voltage fast activity, appeared in the eegs of nearly all of the patients who had been on therapeutic doses of Librium for several days. Seemingly, clinical improvement and the appearance of the Librium effect generally coincide. Speculation as to the site or sites of Librium action was stimulated by observations made during this study. The Librium effect may operate on a cortical level, and the tendency of abnormal patterns presumed to be of subcortical origin to disappear or to become less frequent under Librium dosage suggests that this drug operates also at a subcortical level. This might held to explain the broad effectiveness of Librium in a variety of disorders.