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Drug Effects on Biofeedback




Although there are excellent textbook chapters and review articles summarizing drug effects on the EEG, there are no comparable resources for blood volume pulse (BVP), electrodermal activity (EDA), electromyography (EMG), respiration rate, and skin temperature (TEMP). The main reason for this knowledge gap is that few studies have directly examined the pharmacological effects of medications and social drugs on these biofeedback measurements. This post is a work in progress with several caveats. The tables are incomplete due to the difficulty of identifying relevant human studies. No studies directly measured BVP, EMG, or skin temperature. Instead, they evaluated muscle relaxation and peripheral circulation. We caution our readers to avoid conflating muscle relaxation with EMG and peripheral circulation with BVP and skin temperature. Drug class members may produce varying physiological changes, sometimes in opposing directions. Finally, individual drug responses can vary widely and may depend on factors like dosage, other drugs, physiology, and health.


Blood Volume Pulse (BVP) and Temperature (TEMP)

Vasodilation may result in increased BVP and skin temperature.

Peripheral Circulation Effects



References

Benarroch E. E. (2012). Endogenous opioid systems: Current concepts and clinical correlations. Neurology, 79(8), 807–814. https://doi.org/10.1212/WNL.0b013e3182662098 Chen, A., & Ashburn, M. A. (2015). Cardiac effects of opioid therapy. Pain Medicine, 16 Suppl 1, S27–S31. https://doi.org/10.1111/pme.12915 Glass, P. S., Gan, T. J., Howell, S., & Ginsberg, B. (1997). Drug interactions: Volatile anesthetics and opioids. Journal of Clinical Anesthesia, 9(6 Suppl), 18S–22S. https://doi.org/10.1016/s0952-8180(97)00122-0 Havakuk, O., Rezkalla, S. H., & Kloner, R. A. (2017). The cardiovascular effects of cocaine. Journal of the American College of Cardiology, 70(1), 101–113. https://doi.org/10.1016/j.jacc.2017.05.014 Jones, R. T. (2002). Cardiovascular system effects of marijuana. Journal of Clinical Pharmacology, 42(S1), 58S–63S. https://doi.org/10.1002/j.1552-4604.2002.tb06004.x

Kaplan S. A. (2005). Alpha-blocker therapy: Current update. Reviews in Urology, 7 Suppl 8(Suppl 8), S34–S42. PMID: 16985889 Katzung, B. G., & Trevor, A. J. (2020). Basic and clinical pharmacology (15th ed.). McGraw-Hill Professional.

Puddey, I. B., Rakic, V., Dimmitt, S. B., & Beilin, L. J. (1999). Influence of pattern of drinking on cardiovascular disease and cardiovascular risk factors--A review. Addiction, 94(5), 649–663. https://doi.org/10.1046/j.1360-0443.1999.9456493.x Yoda, T., Crawshaw, L. I., Nakamura, M., Saito, K., Konishi, A., Nagashima, K., Uchida, S., & Kanosue, K. (2005). Effects of alcohol on thermoregulation during mild heat exposure in humans. Alcohol, 36(3), 195–200. https://doi.org/10.1016/j.alcohol.2005.09.002


Electrodermal Activity (EDA)


EDA Drug Effects


References

Dawson, M. E., Schell, A. M., & Filion, D. L. (2000). The electrodermal system. In J. T. Cacioppo, L. G. Tassinary, & G. G. Berntson (Eds.), Handbook of psychophysiology (pp. 200–223). Cambridge University Press.

Ferguson J. M. (2001). SSRI antidepressant medications: Adverse effects and tolerability. Primary Care Companion to the Journal of Clinical Psychiatry, 3(1), 22–27. https://doi.org/10.4088/pcc.v03n0105

Heal, D. J., Smith, S. L., Gosden, J., & Nutt, D. J. (2013). Amphetamine, past and present--A pharmacological and clinical perspective. Journal of Psychopharmacology, 27(6), 479–496. https://doi.org/10.1177/0269881113482532 Martin, C. S., & Earleywine, M. (1990). Ascending and descending rates of change in blood alcohol concentrations and subjective intoxication ratings. Journal of Substance Abuse, 2(3), 345–352. https://doi.org/10.1016/s0899-3289(10)80006-9 Rickels, K., Fox, I. L., Greenblatt, D. J., Sandler, K. R., & Schless, A. (1988). Clorazepate and lorazepam: Clinical improvement and rebound anxiety. The American Journal of Psychiatry, 145(3), 312–317. https://doi.org/10.1176/ajp.145.3.312 Zaccara, G., & Schmidt, D. (2016). Do traditional anti-seizure drugs have a future? A review of potential anti-seizure drugs in clinical development. Pharmacological Research, 104, 38–48. https://doi.org/10.1016/j.phrs.2015.12.011

Electromyography (EMG)


Muscle relaxation and reduced muscle spasms may reduce EMG.

Skeletal Muscle Drug Effects

References

Alleyne, J., & Dopico, A. M. (2021). Alcohol use disorders and their harmful effects on the contractility of skeletal, cardiac and smooth Muscles. Advances in Drug and Alcohol Research, 1, 10011. https://doi.org/10.3389/ADAR.2021.10011 Griffin, C. E., 3rd, Kaye, A. M., Bueno, F. R., & Kaye, A. D. (2013). Benzodiazepine pharmacology and central nervous system-mediated effects. The Ochsner Journal, 13(2), 214–223. PMID: 23789008 Gruenthal, M., Mueller, M., Olson, W. L., Priebe, M. M., Sherwood, A. M., & Olson, W. H. (1997). Gabapentin for the treatment of spasticity in patients with spinal cord injury. Spinal cord, 35(10), 686–689. https://doi.org/10.1038/sj.sc.3100481 Katzung, B. G., & Trevor, A. J. (2020). Basic and clinical pharmacology (15th ed.). McGraw-Hill Professional. Zajicek, J., Fox, P., Sanders, H., Wright, D., Vickery, J., Nunn, A., Thompson, A., & UK MS Research Group (2003). Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): Multicentre randomised placebo-controlled trial. Lancet, 362(9395), 1517–1526. https://doi.org/10.1016/S0140-6736(03)14738-1


Respiration Rate


Respiration Rate Drug effects


References

Cruickshank, C. C., & Dyer, K. R. (2009). A review of the clinical pharmacology of methamphetamine. Addiction, 104(7), 1085–1099. https://doi.org/10.1111/j.1360-0443.2009.02564.x Dahan, A., Aarts, L., & Smith, T. W. (2010). Incidence, reversal, and prevention of opioid-induced respiratory depression. Anesthesiology, 112(1), 226–238. https://doi.org/10.1097/ALN.0b013e3181c38c25

Hoffman R.S., & Howland M, & Lewin N.A., & Nelson L.S., & Goldfrank L.R.(Eds.), (2015). Goldfrank's toxicologic emergencies (10th ed.). McGraw Hill. https://accessemergencymedicine.mhmedical.com/content.aspx?bookid=1163&sectionid=64552562 Mello, N. K., & Mendelson, J. H. (1970). Experimentally induced intoxication in alcoholics: A comparison between programmed and spontaneous drinking. The Journal of Pharmacology and Experimental Therapeutics, 173(1), 101–116.

Sisson J. H. (2007). Alcohol and airways function in health and disease. Alcohol, 41(5), 293–307. https://doi.org/10.1016/j.alcohol.2007.06.003



Glossary


Alcohol: Ethanol, a psychoactive substance characterized as a central nervous system depressant with the potential for addiction and physical dependence.


Alpha-1 blockers: Drugs that inhibit alpha-1 adrenergic receptors, resulting in vasodilation and reduced systemic vascular resistance and blood pressure; primarily used in managing hypertension and benign prostatic hyperplasia.


Amphetamine: Central nervous system stimulant that promotes neurotransmitter release, specifically dopamine, norepinephrine, and serotonin; used therapeutically to manage attention deficit hyperactivity disorder (ADHD) and narcolepsy.


Antiepileptics: Anticonvulsants are a diverse group of pharmacological agents used to prevent epileptic seizures.


Antipsychotics: Medications primarily used to manage psychosis, including delusions, hallucinations, paranoia, or disordered thought, principally in schizophrenia and bipolar disorder; work by modulating neurotransmitter activity.


Benzodiazepines: Psychoactive drugs that enhance the effect of the neurotransmitter gamma-aminobutyric acid (GABA) at the GABA-A receptor, producing sedative, hypnotic, anxiolytic, anticonvulsant, and muscle relaxant effects.


Beta blockers: A class of medications predominantly used to manage abnormal heart rhythms and protect the heart from a second heart attack (myocardial infarction) after a first heart attack (secondary prevention). They work by blocking the effects of adrenaline on beta receptors, reducing heart rate and blood pressure.


Calcium channel blockers: Drugs that disrupt the movement of calcium through calcium channels used in managing hypertension, angina pectoris, and some types of arrhythmia.


Cannabis: Marijuana is a plant that contains over 100 different chemical compounds called cannabinoids. The two most well-known cannabinoids are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the primary psychoactive compound that gives cannabis its mind-altering effects. In contrast, CBD is non-psychoactive and has been researched for its potential therapeutic effects on conditions like epilepsy, anxiety, and chronic pain.


Cocaine: A potent stimulant drug derived from the coca plant, and it is primarily recognized as a tropane alkaloid. Its scientific name is benzoylmethylecgonine. As a central nervous system stimulant, cocaine works by inhibiting the reuptake of neurotransmitters such as dopamine, norepinephrine, and serotonin in the brain, resulting in their increased concentrations.


Methamphetamine: A potent central nervous system stimulant that affects the release, reuptake, and metabolism of monoamine neurotransmitters, particularly dopamine; used clinically in treating ADHD and obesity, but also associated with illicit use and addiction.


Narcotics: A broad term often used to refer to opioids, a class of drugs that interact with opioid receptors in the brain to produce analgesic effects; used for pain management but also associated with high risk of addiction and overdose.


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