Neuroleptics: what are these drugs and when are they used?

Representatives of a large group of drugs that have antipsychotic effects, along with the manifestation of side effects, prescribed for the treatment of mental disorders, are called neuroleptics, psycholeptics, antipsychotics.

Contents:

• What are neuroleptics?
• Classification of
• Action of neuroleptics
• Treatment of
• Removal of neuroleptics
• Neuroleptics of the new generation
• Side effects of
• Contraindications

What are neuroleptics?

Neuroleptic drugs, which are currently represented by a fairly large number of medicines, are intended to provide medical care to people with mental disorders.

The group of antipsychotics:

• Includes psychotropic drugs that differ in active substance, in the variety of pharmacological and therapeutic properties, in the effectiveness of
• . The pharmacological properties of the preparations are due to their chemical structure, the presence of a fragment responsible for the manifestation of a specific effect.
• .Calming with a decrease in the response to external stimuli, weakening psychomotor agitation, stressHallucinations
• Has antipsychotic effect, accompanied by neurological, extrapyramidal disorders, neuroleptic syndrome
• Antipsychotic effect due to blockade of dopamine receptors of the brain of different locations that are responsible for the occurrence of mental disorders
• Has a sedative effect orEnergizing action
• Affects a number of neurochemical processes in the(Dopaminergic, adrenergic, serotonergic, cholinergic, neuropeptide)
• Causes a range of side effects, with a wide range of severity
• Characterized by a phenomenon called the "antipsychotic threshold", with a decrease in which there is no implementation of the drug as an antipsychotic,With the manifestation of only nonspecific effects, hypnotic, sedative, anti-anxiety, antiemetic

Use of neuroleptic drugs forTreatment of patients suffering from various mental disorders presupposes knowledge of their pharmacological properties, effectiveness, mechanism of action.

From the video you can get more information about neuroleptics.

Classification of neuroleptics

Due to the fact that the group of neuroleptics includes drugs that sometimes have sharp differences in both neurochemical and clinical properties, it became necessary to classify them according to certain criteria that would guide the doctor when deciding on the choice of the tactics of the treatment process.

Neuroleptics are classified according to the following criteria:

• By the features of the chemical structure and structure of phenothiazine, thioxanthene, benzamide, piperazine, piperidine, indole derivatives, dibenzothiapines, dibenzoxazepines.Such a systematization is the closest to pharmacologists, it allows to predict the effectiveness of the drug, the manifestation of adverse reactions, evaluate the risk of toxicity, pharmacokinetics of the drug.For practitioners, the use of this separation is subject to certain restrictions.
• By the specificity of neurochemical mechanisms of action primarily on the blockade of dopamine receptors, the degree of binding to them and the severity of the effect as antipsychotic.Such a systematization is important from a practical point of view, since it allows one to assume, including, the tolerability of the drug, but it has drawbacks.
• By the nature of the clinical effect on the basis of the severity of the action as an antipsychotic, taking into account the profile of adverse reactions.Systematization is really useful to practitioners because it makes it easier to select individual drugs.
• The severity of the antipsychotic effect is the isolation of high-grade and low-potential antipsychotics by the ability to induce the weakening of clinical manifestations of mental disorders, to prevent the progression of the disease.Systematization is to some extent conditional.
• By the difference in clinical effect in combination with the manifestation of side effects on the so-called atypical and typical neuroleptic drugs.Sufficient conditional separation.
• For the duration of the action, including prolonged.

The systematization of neuroleptic remedies is not absolute, is sufficiently conditional, it does not always make it possible to relate the drug to a certain group with certainty.

The action of the neuroleptics

The different representatives of neuroleptic drugs unite the general mechanism of action, which consists in blockade of receptors of neurotransmitter systems, mainly dopamine and serotonin, responsible for the appearance of psychotic symptoms.

It is thanks to this mechanism that the main effect of antipsychotics, antipsychotic, is manifested.

The affinity of antipsychotics for a number of other receptors, acetylcholine, adrenaline, histamine, which causes a relatively wide spectrum of action, manifested, among other things, in the side effects of this group of drugs is demonstrated.

Among the effects of neuroleptic drugs are noted:

• Antipsychotic as a general, which is directed at all symptoms of a mental disorder, as well as preventing the progress of the disease, and selective, consisting in targeting the symptoms of the productive, including the manifestations of delirium, hallucinations,Obsessive states.
• Antipsychotic effects are often associated with sedation, resulting in these drugs are effective for the therapy of psychomotor excitement, sleep disorders, or with activating - for the treatment of apathy, catonic stupor.
• Cognitotrophic, reflected in the impact on the functional manifestations of memory, thinking, perception, concentration.
• Neurological, affecting the manifestation of side effects in the form of muscle stiffness, restlessness, tremor of extremities.

The effect on the functioning of the autonomic nervous system, the endocrine system, which is manifested in such side effects as hypotension, dry mouth, urination disorders, sexual disorders, obesity.

A wide range of neuroleptic drugs is expressed in varying degrees among individual members of this group of drugs.

Treatment with neuroleptics

The use of neuroleptics for the treatment of patients with various kinds of mental disorders presupposes an individual approach, the collection and analysis of an anamnesis, a comprehensive examination using clinical and laboratory methods, including analysis of urine samples, blood, cardiac and liver function.

Based on the totality of the data obtained, taking into account the nature of the disease state, the symptomatology is positive or negative, the doctor selects the most appropriate drug in each specific case, determines the treatment regimen.

Treatment, regardless of the drug chosen, begins with the use of small doses with a gradual increase in them to achieve the most effective.

When the therapeutic effect is achieved, the doctor decides whether to use the drug or replace it for a supportive, anti-relapse course, usually by prescribing long-acting drugs.

The appointment of antipsychotics is indicated:

• In acute and chronic forms of psychoses of different nature
• In syndromes accompanied by psychomotor agitation, psychotic, manic, psychopathic, anxious
• In schizophrenia in the form of an exacerbation for the correction of
• status In syndromes with hyperkinetic motorDisorders, including Huntington's chorea
• In psychopathies with behavioral disorders
• In psychosomatic disorders
• In bipolar affective disorders

It is advisable to prescribe antipsychotics only on indications during medical monitoring of the patient's condition.

Removal of neuroleptics

For the treatment of patients with mental disorders it is extremely important to accurately observe the dosage of neuroleptic drugs and the features of their use, including the observance of the time intervals between their reception.

Since such patients undergo medical treatment under the supervision of a doctor, only the doctor has the right to decide on discontinuing the course, changing the dose, changing the drug.

This is especially important due to the existence of the so-called withdrawal syndrome of neuroleptic drugs, which manifests itself when the course is interrupted, the dose changes towards its decrease.

The syndrome is characterized by the manifestation of mental, neurological, vegetative disorders that develop, as a rule, in a few days or longer for a period of time, subject to suspension of treatment, rejection of it, or in cases of administration of another drug of this group.

The mechanism of this kind of phenomena is associated with the emergence of a pharmacodynamic stress situation with the available adaptive dependence and pronounced hypersensitivity of dopamine mediator systems, especially in cases of prolonged administration of neuroleptics.

The clinical picture of withdrawal syndrome is characterized by the return of previous symptoms of a psychotic disorder, and sometimes the emergence of new ones.

Manifestations in the patient of "recoil" psychosis require attention from the physician for differentiation of this condition and aggravation of the psychiatric disorder, for which the neuroleptic drug was prescribed.

To prevent the occurrence of withdrawal syndrome, discontinuation of treatment, replacement of the drug and dosage changes should be made by the doctor with a gradual, gradual dose reduction.

Neuroleptics of the new generation

The development of new methods for the treatment of mental disorders is reflected in the creation of a new class of drugs called atypical antipsychotics, atypical antipsychotics.

A distinctive feature of these drugs is a lower degree of relationship to the receptors of dopamine than typical representatives of neuroleptics, and the ability to bind to other types of receptors.

Similar features led to a change in the pharmacological properties of drugs, including in the manifestation of side effects, tolerability.

Atypical antipsychotics:

• Characterized by the absence of manifestations of extrapyramidal, motor disorders in the form of parkinsonism, dystonia, tremor, chorea, or a rare incidence of
• . Do not increase the level of prolactin, or the probability of this phenomenon is significantly lower than in typicalAntipsychotic
• Have a positive effect on the manifestation of negative symptoms, cognitive impairment
• Possess a much higher degree of anatomyInfluence on the metabolism of a number of neurotransmitters, including serotonin, and less on the metabolism of dopamine
• . They are characterized by a relatively low risk of developing concomitant adverse reactions; however, they can cause metabolic disorders, and as a result, obesity, heart and vascular diseases, diabetes

Neuroleptic drugs of the new generation, atypical, represent a group of drugs with a wide range of manifestations of pharmacological properties, mechanisms of action, effectiveness, side effect, tolerability.

Neuroleptics: side effects

In appointing neuroleptics for the treatment of mental disorders of various nature, the risk of unwanted effects developing in the form deserves special attention:

• Neuroleptic syndrome, extrapyramidal disorders affecting motor functions, in hypokinetic or hyperkinetic terms
• Discovery
• Acethesia
• Functional disorders of the autonomic nervous system
• Failure functionedOf the endocrine system
• Cardiac disorders
• Violations in the genital area due to an increase in the level of prolactin in the blood
• Mental disturbances manifested in exacerbation of depression, sleep problems
• General allergic and toxic reactions

The severity of unwanted effects isDependencies:

• Based on the individual sensitivity and / or intolerance of the drug
• From the drug dose
• From the drug interaction of medications prescribed to the patient
• From the general condition, from the age of the patient

The undesirable effects that occur in patients with psychiatric disorders with the appointment of neuroleptics are manifested in the form of short-term side effects, usually discontinuing as treatment continues, or asComplications that significantly affect the patient's condition.

Most often, these kinds of phenomena are largely programmed by the features of the drugs of this group of drugs, predictable.

Manifestations of unwanted effects in the administration of antipsychotics vary significantly, but are usually expressed to a lesser degree in new-generation drugs, atypical antipsychotics.

Contraindications

The administration of neuroleptic drugs to patients is carried out according to the indications given the specificity of the mental disorder.

There is, however, a fairly wide range of contraindications to their prescription, including:

• Individual sensitivity and / or intolerance of a given drug or its components
• Allergy manifestations of this group of drugs
• A history of cardiovascular-Vascular insufficiency, functional damage to the liver, kidneys, blood diseases
• Pregnancy status at any stage, breastfeeding
• Diseases of the eyecoma, enlarged prostate, a toxic form of agranulocytosis, porphyria, Parkinson's disease, pheochromocytoma
• coma, fever in acute

requires special attention purpose of antipsychotics for children.

In order to prevent serious complications in the health of patients, the doctor necessarily checks contraindications to the appointment of a particular antipsychotic.

Neuroleptic drugs are characterized by a wide range of effects, expressed in varying degrees in the representatives of this group of drugs.