In psychiatry are widely used neuroleptics - the list of drugs is huge. Drugs of this group are used when excessive excitation of the central nervous system. Many of them have a huge list of contraindications, so the doctor should prescribe them and prescribe the dosage.
Neuroleptics - mechanism of action
This class of drugs has appeared recently. Previously, opiates, belladonna or bleach were used to treat patients with psychoses. In addition, intravenously injected bromides. In the fifties of the last century, patients with psychoses were prescribed antihistamines. However, after a couple of years, neuroleptics of the first generation appeared. Their name is due to the effect on the body. From the Greek "νεῦρον" is literally translated "neuron" or "nerve", and "λῆψις" - "capture".
In simple terms, the neuroleptic effect is the effect that the drugs of this drug group have on the body. These medications are distinguished by such pharmacological effects:
- have a hypothermic effect (drugs contribute to lower body temperature);
- have a sedative effect (medicines soothe the patient);
- provide antiemetic effect;
- have a tranquilizing effect;
- provide antihypertensive effects;
- have anti-icicle and antitussive effects;
- normalize behavior;
- contribute to a decrease in vegetative reactions;
- potentsiruyut action of alcoholic beverages, narcotic analgesics , tranquilizers and hypnotics.
Classification of antipsychotics
The list of drugs in this group is considerable. There are different antipsychotics - the classification includes differentiation of drugs on different grounds. All neuroleptics are conventionally divided into such groups:
- typical;
- atypical.
In addition, neuroleptic drugs differentiate according to the clinical effects of the drug:
- sedative;
- stimulating;
- antipsychotic.
According to the duration of exposure, antipsychotics may be:
- drugs with a short-term effect;
- long-acting drugs.
Typical antipsychotics
Preparations of this medication group are distinguished by high medical capabilities. These are antipsychotics. When they are taken, the likelihood of side effects will begin to appear. Such antipsychotics (the list of medications is considerable) can be derived from the following compounds:
- phenothiazine;
- thioxanthene;
- butyrophenone;
- indole;
- benzodiazepine;
- diphenylbutylpiperidine.
In this case, phenothiazines are differentiated by their chemical structure into such compounds:
- possessing a piperazine core;
- having an aliphatic bond;
- with a pyridine nucleus.
In addition, antipsychotics (the list of drugs given below) on the effectiveness can be differentiated into such groups:
- soothing agents;
- activating drugs with antidepressant effect;
- strong antipsychotics.
Atypical antipsychotics
These are modern medicines that are capable of exerting such an effect on the body:
- improve concentration of attention and memory;
- have a sedative effect;
- have antipsychotic effect;
- differ neurological effects.
Atypical antipsychotics have such advantages:
- motor pathologies are very rare;
- a low probability of complications;
- the index of prolactin almost does not change;
- with ease such drugs are excreted by the excretory system;
- almost do not affect the metabolism of dopamine;
- are more easily tolerated by patients;
- can be used in the treatment of children.
Neuroleptics - indications for use
Drugs of this group are prescribed for neuroses of different etiology. They are used to treat patients of any age, including children and the elderly. Neuroleptics testimony have these:
- chronic and acute psychosis;
- psychomotor agitation;
- chronic insomnia ;
- incessant vomiting;
- Tourette's syndrome ;
- disorders of somatoform and psychosomatic nature;
- mood swings;
- phobias ;
- motor disorders;
- preoperative preparation of patients;
- hallucinations and so on.
Side Effects of Neuroleptics
The probability of developing an undesirable reaction depends on such factors:
- the applied dosage;
- duration of therapy;
- the age of the patient;
- his state of health;
- interaction of the drug taken with other drugs that the patient drinks.
More often such side effects of neuroleptics are manifested:
- violations of the endocrine system, it is often the reaction of the body to long-term use of drugs;
- increase or decrease in appetite, and weight changes;
- excessive drowsiness, which is observed in the first days of taking the drug;
- increased muscle tone, slurred speech and other manifestations of neuroleptic syndrome, dosage adjustment helps to correct the situation.
Significantly less pronounced is the action of neuroleptics:
- temporary loss of vision;
- abnormalities in the work of the digestive tract (constipation or diarrhea);
- trouble urinating;
- dry mouth or strong salivation;
- lockjaw;
- problems with ejaculation.
The use of neuroleptics
There are several schemes for prescribing medicines for this group. Neuroleptic drugs can be used as follows:
- Quick method - the dose is brought to the optimal within 1-2 days, and after that the entire course of treatment is maintained at this level.
- Slow build-up implies a gradual increase in the amount of the drug taken. After the entire therapeutic period, it is maintained at an optimal level.
- Zigzag method - the patient takes the drug in high doses, then sharply reduces, and then increases again. This pace is the entire therapeutic course.
- Treatment with the drug with pauses in 5-6 days.
- Shock therapy - twice a week the patient takes the drug in very high doses. As a result, his body undergoes a chemoshock, and psychoses cease.
- Alternating method - the scheme by which various psychotropic medications are consistently applied.
Before appointing antipsychotics (the list of drugs is extensive), the doctor will conduct a checkup to determine if the patient has contraindications. From therapy with medications this group will have to refuse in each of such cases:
- pregnancy;
- the presence of glaucoma;
- pathology in the work of the cardiovascular system;
- an allergy to antipsychotics;
- feverish condition;
- breastfeeding and so on.
In addition, the neuroleptic effect of the drugs in this group depends on what medications are taken with them simultaneously. For example, if such a drug is drunk with antidepressants, this will lead to an intensification of the action of both the first and the second. With such a duet, constipation is often observed and blood pressure rises. However, there are undesirable (sometimes dangerous) combinations:
- Simultaneous reception of neuroleptics and benzodiazepines can provoke respiratory depression.
- Antihistamines in a duet with antipsychotics lead to a malfunction in the CNS.
- Insulin, anticonvulsant, antidiabetics and alcohol reduce the effectiveness of neuroleptics.
- Simultaneous administration of antipsychotics and tetracyclines increases the likelihood of liver damage by toxins.
How long can I take antipsychotics?
Scheme and duration of treatment is prescribed by the doctor. In some cases, the doctor, after analyzing the dynamics of therapy, can calculate that there is enough and a 6-week course. For example, so take sedative neuroleptics. However, in most cases this course is not enough to achieve a lasting result, so the doctor prescribes long-term therapy. In individual patients, it can last a lifetime (from time to time short breaks are made).
Removal of antipsychotics
After stopping the use of medication (this is most often observed when taking a representative of a typical group), the patient's condition may worsen. The neuroleptic withdrawal syndrome begins to manifest itself immediately. It is leveled within 2 weeks. To ease the patient's condition, the doctor can gradually translate it from antipsychotics to tranquilizers. In addition, the doctor in such cases still prescribes vitamins of group B.
Neuroleptic drugs - list
Antipsychotics are represented in a huge variety. The specialist has the opportunity to select the optimal neuroleptics for a particular patient - the list of drugs is always at hand. Before making an appointment, the doctor assesses the condition of the person applying to him and only after that makes a decision about which medication to prescribe to him. In the absence of the desired result, the neuroleptic may be reassigned by a specialist - the list of drugs will help to select a "replacement". At the same time, the doctor will prescribe the optimal dosage of the new medicine.
Generations of antipsychotics
Typical antipsychotics are represented by such drugs:
- Chlorpromazine;
- Haloperidol;
- Molindon;
- Thioridazine and so on.
The most popular neuroleptics of the new generation without side effects:
- Abilifay;
- Fluphenazine;
- Quetiapine;
- Fluanexol;
- Triftazine;
- Levomepromazine.
Neuroleptics - list of products without prescriptions
There are few such medicines. However, one should not think that self-medication is safe for them: even antipsychotics dispensed without prescriptions should be taken under the supervision of a doctor. He knows the mechanism of action of these medicines and will recommend the optimal dosage. Neuroleptic drugs without prescriptions - a list of available medicines:
- Olanzapine;
- The Serdolect;
- Ariprizol;
- Etperazine;
- Chlorprotixen.
The best antipsychotics
The most safe and effective are considered atypical drugs. Neuroleptics of the new generation are more often prescribed:
- Sertindol;
- Solian;
- Zeldox;
- Lakvel;
- Clozapine;
- Depral;
- Prosulfin;
- Betamax;
- Limipranil and others.