Neurocritical Care

, Volume 7, Issue 2, pp 124–127

Effect of loxapine on electrical brain activity, intracranial pressure, and middle cerebral artery flow velocity in traumatic brain-injured patients

  • Thomas Lescot
  • Ana Rosa Pereira
  • Lamine Abdennour
  • Paola Sanchez-Pena
  • Lionel Naccache
  • Pierre Coriat
  • Louis Puybasset
Brief Communication

DOI: 10.1007/s12028-007-0051-7

Cite this article as:
Lescot, T., Pereira, A.R., Abdennour, L. et al. Neurocrit Care (2007) 7: 124. doi:10.1007/s12028-007-0051-7

Abstract

Introduction

Delirium is a frequent complication of traumatic brain injury, especially during the weaning period. Antipsychotic drugs are often used in this case. Loxapine is a tricyclic antipsychotic drug with sedating properties. The effects of intravenous loxapine on EEG as well as on systemic and cerebral hemodynamics after traumatic brain injury are unknown.

Methods

Seven sedated and mechanically ventilated traumatic brain injured patients were studied 11 ± 5 days after trauma. They were on continuous perfusion of sufentanil and midazolam. Left and right spectral edge frequency (SEFl, SEFr) of continuous EEG recording, intracranial pressure (ICP), mean flow velocity of the middle cerebral artery (MFVMCA) and mean arterial pressure (MAP) were simultaneously recorded and digitalized before and after loxapine infusion (10 mg in 10 min of continuous infusion).

Results

Loxapine induced no significant change on MAP, MFV. On the contrary, it decreased ICP and both SEFl, SEFr. ETCO2 and the dose of vasopressors were not altered during the study period.

Conclusion

10 mg of loxapine administered intravenously over 10 min decreased brain electrical activity. There is a concomitant reduction in ICP without any significant change in cerebral blood flow velocity. The use of intravenous loxapine to control agitation is not accompanied by deleterious hemodynamic or systemic effects in ICU’s traumatic brain injured patients.

Keywords

Traumatic brain injury Delirium Loxapine Agitation Antipsychotics Continuous electroencephalogram monitoring Intracranial pressure 

Copyright information

© Humana Press Inc. 2007

Authors and Affiliations

  • Thomas Lescot
    • 1
  • Ana Rosa Pereira
    • 1
  • Lamine Abdennour
    • 1
  • Paola Sanchez-Pena
    • 1
  • Lionel Naccache
    • 2
  • Pierre Coriat
    • 1
  • Louis Puybasset
    • 1
    • 3
  1. 1.Department of Anesthesiology and Critical CareGroupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Pierre et Marie Curie-Paris 6ParisFrance
  2. 2.Clinical Neurophysiology DepartmentGroupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP),Université Pierre et Marie Curie-Paris 6ParisFrance
  3. 3.Département d’Anesthésie-RéanimationGroupe Hospitalier Pitié-SalpêtrièreParisFrance

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