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                  <text>March 29, 1979

Turan Itil, M.D.
Research

HZI

Tarrytown,

New York

Dear Turan,

I have had a chance to read the Final Report
Task Force on
with some
attention to the details, and Bioavailability
I am writing because I believe
the report is less sanguine than need be with regard to the
methods already available to us to assess bioavailability
and pharmacodynamics of drugs. Specifically, the section
7.2.2 should be expanded in some way to reflect the state of
knowledge presented at our sessions. You may recall that two
methods were discussed at length as
the changes in
brain function induced by drugs whichreflecting
crossed the brood-brain bustier
barrier, that of pupillography and of quantitative electroencephalography. These methods provide valid end~points to
the effects of drugs on the brain, and
as quantitative as
established biochemical methods in this are
regard.

of the

by

ACNPwFDA

Would you consider amending the paragraph 7.2.2
the addition of the following:
". . . There is currently no recognized standard

approach, although pharmacodynamic methods such as the
quantitative EEG and pupillography, which are responsive to
the effects of drugs which cross the blood-brain barrier,
provide the most logical opportunity for such development."
Quantitative EEG methods provide indices
the assessment
of benzodiazepines (diazepam, bromazepam),formianserin,
doxephn,

thiothixene, phenytoin, among others, in studies from my
laboratory alone. Others have made similar contributions, and
the negative statement of 7.2.2 ought to reflect this experience.
My best regards.
Sincerely yours,
Max

Fink, M.D.

Professor of Psychiatry

�Y'"

m...

wwwknm

April
Turan
HZI

Itil,

Research

150 White

Tarrytown,

-

10 , 1978

M.D.

l

Plains

Rdd

New York

Dear Turan,

It

nice seeing you again, and we did enjoy the
visit with Ellen. I felt a bit better after the debacle in
Ottawa since we did have the occasion to talk again.
was

I enclose the reprints from the recent work by
Bolwig. It is the clearest data that ECT produces an increase
in permeability of the blood—brain barrier, and is quite compelling.
Maybe it could be used in the TR? problem.
My

best regards.
Sincerely yours,

Max

Fink,

M.D.

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