Antipsychotic drugs, their properties and use. Cognitive effect of neuroleptics. Antipsychotics of a new generation without side effects

With neuroses, depressive states, doctors prescribe antipsychotics. A number of drugs can be bought at a pharmacy without a prescription - they strict rules do not apply.

Antipsychotics without a prescription - types, groups, indications

In pharmacology, neuroleptics are understood as antipsychotics, or antipsychotic drugs. These drugs are preferred in the treatment of nervous, psychological, mental disorders. The action of the funds is powerful, but side effects are also common, so they are taken only according to indications.

There are two types of antipsychotics - typical and atypical, their main differences are in the table:

Due to the negative impact on the body, the drugs of the first group are almost never used, only in a hospital setting, some of them are used in patients with schizophrenia. Modern, atypical neuroleptics in some cases are sold without a prescription, as they are recognized as safe for the patient. They calm, relieve stress, clean muscle spasm, reduce manifestations of neuroses.

Olanzapine is a popular drug

In the list of group drugs that can be bought without a prescription, Olanzapine occupies the leading line. It belongs to the atypical antipsychotics of the new generation, its price is low - 130 rubles for 28 tablets. Consists of the eponymous active substance, a number of auxiliary components.

The drug acts on dopamine and serotonin receptors.

Olanzapine acts as follows - it selectively lowers the excitability of a number of neurons, while improving performance neural pathways responsible for motor functions. decrease during treatment negative manifestations, there is a pronounced anti-anxiety effect.

Side effects Olanzapine is more often observed with a long course or exceeding the dosages indicated by the doctor:

In isolated cases, there were sharp rise sugar, ketoacidosis, hepatitis, blood disorders. Indications include various psychotic disorders, neurotic seizures. It is forbidden to purchase and take the drug during pregnancy, renal, liver failure in people under 18 years of age. The dose is 10 mg / day, it can be increased only according to strict indications! Analogues with the same active substance are Zyprexa Zidis, Zalasta, Egolanza.

Medicines based on risperidone

Such funds are found wide application in neurological and psychotherapeutic practice. The active ingredient risperidone is part of a whole list of non-prescription antipsychotic drugs. Risperidone - strong antipsychotic, in parallel has a number of other effects:

Risperidone binds to serotonin and dopamine receptors, and also interacts with H1-histamine receptors. The medicine copes well with both serious mental disorders (delusions, hallucinations, manifestations of schizophrenia), and helps with more common problems - neuroses, depression, nervous overexcitation. Among others, the indications of risperidone include:

• Alzheimer's disease;
• senile dementia;
• aggressive behavior in children 5-16 years old.

by the most an inexpensive drug is Risperidone - it costs 150 rubles for 20 tablets, you can also buy Risset for 160 rubles, Ridonex for 320. Rispaxol, Rileptid cost about 600-700 rubles, and the medicine Rispolet in the form of powders for suspension is sold for 4500 rubles.

Ariprizol and Serdolect

The drugs have a similar mechanism of action and are fairly safe for the treatment of psychosis. The cost of Ariprizol is very high - more than 5500 rubles / 30 tablets, so it is better to purchase it with the approval of a specialist and according to strict indications. As part of the neuroleptic aripiprazole, acting on the system of nerve receptors and giving a powerful sedative and antipsychotic effect.

The therapeutic effect of treatment usually develops in 3-5 days and increases with time.

The drug is indicated for any depressive disorders, but in some cases it must be combined with antidepressants. With great care, treatment is carried out in patients with cardiac pathologies, a number of side effects(arrhythmia, heart failure, hypotension).

The medicine Serdolect costs less - 2200 rubles / 30 tablets. They can replace the drug described above, since their action is similar. It is forbidden to give Serdolect for any moderate to severe heart disease, with a reduced level of potassium and magnesium in the blood, for children, pregnant women.

What other neuroleptics are on sale?

There are not many drugs of this group on the pharmacological market that can be purchased at pharmacies without a prescription. Means of the first generations are not sold at all in the commercial network and are available only in state pharmacies.

AT childhood from the age of 3, the medicine Clozapine is prescribed - a strong antipsychotic with a number of serious side effects.

How soft sedative experts often advise the neuroleptic Tizercin (Levomepromazine). It has a positive effect on the vegetative nervous system reducing the frequency of mood swings, depressive states, asthenic manifestations. Also drug:

Another remedy is Quetiapine (680 rubles) with the active substance of the same name. Its great advantage is that it does not affect hormonal system organism. Even with long-term use prolactin levels remain the same. Side effects are also rare - headaches, dizziness, diarrhea or constipation, increased levels of liver enzymes (reversible) prevail among them. The drug is widely used against various types depressive disorders.

Other known antipsychotics:

• Invega;
• Eglonil;
• Aminazin;
• Leponex;
• Melleril.

The course of admission can be months, but the longer it is, the higher the risk of developing a withdrawal syndrome. You need to stop taking medication in stages, gradually reducing the dose.

What to take if there are contraindications?

Manufacturers produce so-called "light" over-the-counter drugs that belong to the group of antidepressants and antipsychotics. They are sold in a pharmacy without a prescription, and clear indications for admission are not required. Basically, they are purchased as sedatives, as well as for chronic stress.

A striking example of a new generation of drugs with a minimum of "side effects" is Afobazol. Its active substance is excellent for:

Occasionally, during therapy, allergies, headaches are observed, but more often the drug is well tolerated. Among effective means you can also specify Adaptol, Paroxetine, Mebicar, Oxylidine. The course of therapy is 1-3 months, it is enough to eliminate neurotic disorders.

Many of those who, for health reasons, had to cross the threshold of a psychiatric office, leave it with several prescriptions for intricate drugs in their hands. The need for admission psychotropic drugs often scary. Fear of side effects, addiction or changes in one's personality - all this introduces a grain of doubt and distrust in medical recommendations. It is regrettable, but sometimes, the main healers are numerous friends, relatives and neighbors on the landing, and not a graduate.

One of the groups of drugs widely used in psychiatry are antipsychotics. If you have been prescribed antipsychotics, get ready to hear a lot of formulaic phrases about their "opportunities". The most typical are:

• antipsychotics turn a person into a "vegetable";
• psychotropic drugs "jam the psyche";
• psychotropic drugs destroy the personality;
• they cause dementia;
• because of neuroleptics you will die in a psychiatric hospital.

The reason for the emergence of such myths is speculation due to a shortage reliable information or inability to understand it correctly. At all times of the existence of "reasonable man", any incomprehensible phenomena were explained by myths and fables. Remember how our distant ancestors explained the change of day and night, eclipses.

In any case, do not rush to panic! Try to approach the problem of neuroleptics from the point of view of evidence-based medicine.

More about neuroleptics

What are neuroleptics?

The neuroleptics are large group drugs used in the treatment of mental disorders. The greatest value of these drugs is the ability to fight psychosis, hence the second name - antipsychotics. Before the advent of neuroleptics, poisonous and narcotic plants, lithium, bromine, and coma therapy were widely used in psychiatry. The discovery in 1950 of Aminazin served as the beginning of a new stage in the development of all psychiatry. Methods of treating psychiatric patients have become much more gentle, and cases of long-term remissions have become more frequent.

Classification of neuroleptics

All antipsychotics are usually classified into two groups:

1. Typical neuroleptics. Classical antipsychotic drugs. Against the background of high therapeutic possibilities, they have enough high probability development of side effects. Representatives: Aminazine, Haloperidol, etc.
2. Atypical neuroleptics. Modern drugs, the distinctive ability of which is a significantly reduced likelihood of development and severity of side effects, primarily neurological ones. These include: Clozapine, Rispolept, Quetiapine, Olanzapine.

Almost every year, new antipsychotics appear on the pharmacological market. Drugs are becoming more effective, safer and more expensive.

How do neuroleptics work?

Indications for the use of neuroleptics

When can a doctor recommend antipsychotics? Not all mental disorders require the use of antipsychotics. Given their exceptional ability to act on delirium, hallucinations, arousal and misbehavior - makes this group of drugs indispensable in the treatment of psychoses of various origins. The ability of neuroleptics to relieve the symptoms of fear, anxiety and agitation allows them to be used quite effectively in anxiety, phobic and depressive disorders. In some cases, antipsychotics can replace tranquilizers, the long-term use of which is unacceptable.

Antipsychotics are designed to deal with the following symptoms:

• psychomotor agitation;
• aggressive and dangerous behavior;
• delusions and hallucinations;
• pronounced feeling of fear;
• tension in the body;
• mood swings;
• apathy and lethargy at;
• bad sleep;
• vomit.

As you can see, the possible range of application of neuroleptics is quite wide, and is not limited exclusively to severe mental disorders.

Side effects of neuroleptics

All medicines, to some extent, other than therapeutic effect have a number of unwanted side effects. There is an opinion about complete security herbal preparations. This is not entirely true. So, long-term use of lemon balm causes dizziness, and excessive passion for chamomile decoctions causes. Even a single overdose of celandine in some cases ends with toxic hepatitis.

The likelihood of side effects and their severity depends on many factors:

• individual sensitivity to the drug;
• the applied dose and duration of treatment;
• route of administration of the drug and its interaction with other drugs;
• the patient's age, general state health.

The main side effects of antipsychotics include:

• neuroleptic syndrome. The reason for its appearance are extrapyramidal disorders. rises muscle tone, movements become slow and constrained, slurred speech is possible. Patients may be disturbed by restlessness in place. When a patient has a neuroleptic syndrome, the doctor will prescribe correctors - drugs that remove the symptoms of neuroleptics.
• endocrine disorders. Occurs with prolonged use large doses neuroleptics.
• Drowsiness. To a greater extent, typical antipsychotics have. Often, drowsiness disappears 3-4 days after the start of antipsychotic treatment.
• Changes in appetite and body weight. Many patients, especially women, most afraid of weight gain. It should be understood that the mere presence of a mental disorder does not predispose to perfect figure. Depression, for example, in many cases significantly changes body weight both up and down, which is mistakenly associated with the action of medications.

Less common side effects include: temporary violations organs of vision, digestive organs (diarrhea, constipation), difficulty with urination and autonomic disorders.

What should a patient taking antipsychotics know?

At the very beginning of a course of treatment with antipsychotics, patients may face not only the manifestation of their side effect, but also the obligation to comply with the rules for taking the drugs. The first weeks will be difficult for both the patient and the doctor. After all, you have to choose the right drug and a sufficient dose. Only mutual trust, responsibility and impeccable striving for results will make it possible to carry out a course of treatment with neuroleptics successfully. The patient must cooperate with the treatment in every possible way, follow the recommendations and report any changes in his condition.

Several simple tips taking antipsychotics:

• Observe the indicated dosage and frequency of administration of drugs. Independent attempts to adjust the dose will only worsen the condition.
• Avoid alcohol, even beer. Antipsychotics interact extremely poorly with alcohol, a joint intake can cause an exacerbation of the disease.
• Since antipsychotics slow down the reaction rate, you will have to wait a little with driving and other mechanisms.
• Eat fully. Eat foods rich in vitamins and protein.
• Drink enough liquids. However, it is undesirable to use strong tea and coffee.
• Be sure to study morning exercises. Even minimal physical activity will be useful.
• Discuss all arising questions on treatment with the doctor, and not grandmothers at the entrance.

The correct use of neuroleptics can cope with many backfire mental disorders, improve the quality of life and give a chance for recovery. Regularly appearing modern drugs minimize the development of side effects, allowing safe treatment long time. Do not be afraid to take antipsychotics and be healthy!

One of the drugs used in psychiatry are neuroleptics. These funds are prescribed to people who have mental, psychological, neurological disorders. Such diseases are accompanied by aggression, phobia, hallucinations. Clearly, the manifestation of schizophrenia can be viewed from the archives of clinics.

Is there a cure for schizophrenia

To identify symptoms in schizophrenics, there are psychological tests. The most popular is the Luscher test, which is presented as a color table. In the process of choosing certain colors, a certain picture is drawn up and a competent specialist is able to reliably decipher it.

The main action of sedative neuroleptics is to remove the reaction to stimuli, neutralize:

• hallucinations;
• Sense of anxiety;
• aggression;
• paranoia;
• An unreasonable state of anxiety.

A large group of these drugs are divided into sedatives and antipsychomatics. Antipsychotics are used primarily to treat schizophrenia. Such drugs reduce psychotic. Antipsychotics are also divided into typical and atypical types.

Typical are antipsychotics with a powerful therapeutic effect.

They have a good antipsychotic effect. The list of side effects in the elderly is negligible or non-existent.

How to cure schizophrenia

Schizophrenia - chronic illness leading to personality disorder. People aged 16-25 can get sick with schizophrenia. Occasionally, the disease manifested itself in children as young as 5 years of age and in people over 45 years of age.

The progressive stage of schizophrenia is characterized by:

• Associative behavior;
• auditory hallucinations;
• References;
• Closure in yourself.

As a rule, patients with schizophrenia are not prone to aggression. Only the use of psychoactive substances (alcohol, drugs) can stimulate the manifestation of violence. The cause of schizophrenia may be acute stress. But this is not the only case of the disease. Any disease of the body can provoke its development.

Therefore, schizophrenia is treated by managing the symptoms.

There is no single answer to the question of whether schizophrenia can be cured completely and forever. Many scientists are fighting for the answer that the disease is curable. But there is certainty that modern methods make it possible to maintain the quality of life. Research into schizophrenia a large number of clinics in Moscow, Novosibirsk, Rostov-on-Don and other cities.

Fundamentals of Schizophrenia Treatment

Every year, new generation drugs appear in the arsenal of doctors. The main part of therapy is the selection of medications. Drugs such as nootropics are used to stimulate the brain, increase cognitive abilities. Below is a list of neuropleeptics recommended by leading experts.

Feedback on them is also positive.

1. Azaleptin. Clozapine is active ingredient. Does not develop catalepsy, oppression of behavior. AT clinical setting Azaleptin has a fast sedation. The medicine is well tolerated by patients. The cost is about 200 rubles.
2. galloper- antipsychotic, neuroleptic, antiemetic. Use with extreme caution in patients with cardiovascular pathology, predisposition to glaucoma, functional disorders liver, and who have epileptic seizures. The price, depending on the form of release, varies from 50 to 300 rubles.
3. Zyprexa zidis round tablets, yellow color. A drug that affects a number of receptor systems. Price from 4000 rubles.
4. Clopixol-Akufaz- injection. Is used for initial stage treatment of acute mental, chronic psychosis (exacerbation). The cost of the drug is 2000–2300 rubles.
5. Senorm- drops for oral administration. Active substance- haloperidol. The cost is about 300 rubles.
6. Propazine- coated tablets blue color with inclusions and marbling. It has less pronounced side effects. The price is about 150 rubles.
7. Triftazin, solution in ampoules 0.2%. The active substance is trifluoperazine. Blocks dopamine receptors in different brain structures. Compatible with other antipsychotics, tranquilizers and antidepressants. The cost of 10 pieces in a package is 50-100 rubles.
8. Chlorprothixene 50 . Analgesic, antidepressant, antipsychotic, antiemetic, sedative. average price- 350 rubles.

Schizophrenia is accompanied by a mood disorder. To take the patient out of given state, use normotimics. Unlike neuroleptics prescribed for mania, normothymic drugs are used for bipolar affective disorder.

Can schizophrenia be cured?

Has not lost its significance for thirty years domestic drug Phenazepam. This is due to the effectiveness of its properties, which are better realized depending on the dose used and the treatment with hypnosis. There is such a method of treatment as cytokine therapy. Cytokines are protein molecules that carry signals from one cell to another, thereby ensuring the coherence of actions immune system, recovery processes various organs, including the brain.

Together with medications, psychological therapy is prescribed. In this case, the doctor selects an approach to the patient on psychological level, conducts treatment by communication.

It is important to involve family in the process of healing the patient. Such treatment makes it possible to induce certain behaviors in the patient, which will help determine probable causes illness. With the help of cognitive-behavioral psychotherapy, the patient is aware of the symptoms of the disease and strengthens control over them. Most patients can lead a productive life. For such people, occupational therapy programs have been created that act as a recovery for the sick.

Gives a relaxing effect tincture of:

• Chamomile;
• Flowers of prickly hawthorn;
• corollas of motherwort;
• Dried herbs.

Treatment folk remedies It may seem impossible, but there are ways. In the fight against schizophrenia, viburnum bark helps. Don't forget about physical exercises. Running can help you get rid of obsessions hallucinations.

List of non-prescription antipsychotic drugs

In some cases, with possible development serious conditions, insulin shock therapy is used. essence this method- placing the patient in a coma. Modern supporters of insulin-comatose therapy recommend its forced course, which includes approximately 20 com. First of all, schizophrenia is treated with antipsychotics. Finding such drugs that are dispensed without a doctor's prescription is quite difficult.

But still, there is a small list:

• Etaperazine;
• paliperidone;
• Chlorprothixene.

Etaperzine - available in the form of tablets, has an inhibitory effect on the nervous system. average cost drug 350 rubles. Paliperidone is effective in the treatment of schizophrenia, schizoaffective bipolar disorders. Price from 13 thousand rubles. Chlorprothixene - the drug has a pronounced antipsychotic and sedative effect, enhances the effect of sleeping pills and analgesics. The average cost is 200 rubles.

Attack of schizophrenia (video)

In conclusion, it is worth noting that neuroleptics are aimed at suppressing these manifestations. Atypical neuroleptics - enough a new group drugs, the effectiveness is not much different from the typical.

A psychotropic drug intended to treat psychotic disorders is called an antipsychotic (also antipsychotic or antipsychotic). What is it and how does it work? Let's figure it out.

Antipsychotic. What it is? History and characteristics

Antipsychotics in medicine appeared relatively recently. Prior to their discovery, drugs with vegetable origin(e.g. henbane, belladonna, opiates), intravenous administration calcium, bromides, and narcotic sleep.

In the early 50s of the 20th century, they began to use for these purposes antihistamines or lithium salts.

One of the very first antipsychotics was chlorpromazine (or chlorpromazine), which until then was considered common. antihistamine. It has been widely used since 1953, mainly as or as antipsychotics (for schizophrenia).

The next neuroleptic was the alkaloid reserpine, but soon gave way to other, more effective drugs because it didn't really work.

In early 1958, other first-generation antipsychotics appeared: trifluoperazine (triftazine), haloperidol, thioproperazine, and others.

The term "neuroleptic" was proposed in 1967 (when the classification of psychotropic drugs of the first generation was created) and it referred to drugs not only having an antipsychotic effect, but also capable of causing neurological disorders (akatasia, neuroleptic parkinsonism, various dystonic reactions and others). Typically, these disorders were caused by substances such as chlorpromazine, haloperidol and triftazin. Moreover, their treatment is almost always accompanied by unpleasant side effects: depression, anxiety, severe fear, emotional indifference.

Previously, antipsychotics could also be called "great tranquilizers", so antipsychotics and tranquilizers are one and the same. Why? Because they also cause pronounced sedative, hypnotic and tranquilizing-anti-anxiety effects, as well as a rather specific state of indifference (ataraxia). Now this name in relation to neuroleptics is not applied.

All antipsychotics can be divided into typical and atypical. We have partially described typical antipsychotics, now we will consider an atypical antipsychotic. a group of softer drugs. They do not act as strongly on the body as typical ones. They belong to the new generation of neuroleptics. The advantage of atypical antipsychotics is that they have less effect on dopamine receptors.

Antipsychotics: indications

All antipsychotics have one main property - an effective effect on productive symptoms (hallucinations, delusions, pseudohallucinations, illusions, behavioral disorders, mania, aggressiveness and arousal). In addition, antipsychotics (mostly atypical) may be prescribed for the treatment of depressive or deficient symptoms (autism, emotional flattening, desocialization, etc.). However, their effectiveness in relation to the treatment of deficient symptoms is under big question. Experts suggest that antipsychotics can only eliminate secondary symptoms.

Atypical neuroleptics, whose mechanism of action is weaker than typical ones, are also used to treat bipolar disorder.

The American Psychiatric Association prohibits the use of antipsychotics to treat the psychological and behavioral symptoms of dementia. Also, they should not be used for insomnia.

It is unacceptable to be treated with two or more antipsychotic drugs at the same time. And remember that neuroleptics are used to treat serious illnesses, it is not recommended to take them just like that.

Main effects and mechanisms of action

Modern antipsychotics have one general mechanism antipsychotic action, because they can reduce the transmission of nerve impulses only in those brain systems in which dopamine transmits impulses. Let's take a closer look at these systems and the effect of antipsychotics on them.

• mesolimbic pathway. A decrease in transmission in this pathway occurs when taking any antipsychotic drug, since it means the removal of productive symptoms (for example, hallucinations, delusions, etc.)
• mesocortical pathway. Here, a decrease in the transmission of impulses leads to the manifestation of symptoms of schizophrenia (there are such negative disorders as apathy, desocialization, poverty of speech, smoothing of affect, anhedonia) and cognitive impairment (attention deficit, impaired memory function, etc.). The use of typical antipsychotics, especially long-term use, leads to increased negative disorders, as well as serious violations brain functions. Cancellation of neuroleptics in this case won't help anything.
• Nigrostriatal path. Blockade of dopamine receptors in this case usually leads to side effects typical of antipsychotics (akathisia, parkinsonism, dystonia, salivation, dyskinesia, trismus of the jaws, etc.). These side effects observed in 60% of cases.
• Tuberoinfundibular pathway (transmission of impulses between the limbic system and the pituitary gland). Blocking the receptors leads to an increase in the hormone prolactin. Against this background, there is great amount other side effects such as gynecomastia, galactorrhea, sexual dysfunction, infertility pathology, and even a pituitary tumor.

Typical neuroleptics have a greater effect on dopamine receptors; atypical ones affect serotonin with other neurotransmitters (substances that transmit nerve impulses). Because of this, atypical antipsychotics are less likely to cause hyperprolactinemia, neuroleptic depression, as well as neurocognitive deficits and negative symptoms.

Signs of blockade of α 1 -adrenergic receptors are a decrease blood pressure, orthostatic hypotension, the development of dizziness, the appearance of drowsiness.

With blockade H 1 -histamine receptors hypotension appears, an increase in the need for carbohydrates and an increase in body weight, as well as sedation.

If blockade of acetylcholine receptors occurs, the following side effects appear: constipation, dry mouth, tachycardia, increased intraocular pressure and disturbances of accommodation. Confusion and drowsiness may also occur.

Western researchers have proven that there is a link between antipsychotics (new antipsychotics or old ones, typical or atypical, it doesn't matter) and sudden cardiac death.

Also, when treated with antipsychotics, the risk of stroke and myocardial infarction is significantly increased. This is because psychotic drugs affect lipid metabolism. Antipsychotics may also cause diabetes 2nd type. chances of getting serious complications increase with combined treatment typical and atypical antipsychotics.

Typical neuroleptics can provoke epileptic seizures, as they lower the threshold for convulsive readiness.

Most antipsychotics (mainly phenothiazine antipsychotics) have a large hepatotoxic effect, and can even cause the development of cholestatic jaundice.

Treatment with antipsychotics in the elderly can increase the risk of pneumonia by 60%.

The cognitive effect of neuroleptics

Conducted open studies have shown that atypical antipsychotics are slightly more effective than typical ones in the treatment of neurocognitive insufficiency. However, there is no convincing evidence of any effect on neurocognitive impairment. Atypical neuroleptics, whose mechanism of action is slightly different from the typical ones, are often tested.

In one of clinical research physicians compared the effects of risperidone and haloperidol at low doses. During the study, no significant differences were found in the readings. Haloperidol at low doses has also been shown to have a positive effect on neurocognitive performance.

Thus, the question of the impact of first or second generation antipsychotics on the cognitive sphere is still controversial.

Classification of antipsychotics

It has already been mentioned above that antipsychotics are divided into typical and atypical.

Typical antipsychotics include:

1. Sedative antipsychotics (having an inhibitory effect after use): promazine, levomepromazine, chlorpromazine, alimemazine, chlorprothixene, periciazine and others.
2. Incisive antipsychotics (have a powerful global antipsychotic effect): fluphenazine, trifluoperazine, thioproperazine, pipothiazine, zuclopenthixol, and haloperidol.
3. Disinhibiting (have an activating, disinhibitory effect): carbidine, sulpiride and others.

Atypical antipsychotics include substances such as aripiprazole, sertindole, ziprasidone, amisulpride, quetiapine, risperidone, olanzapine, and clozapine.

There is another classification of antipsychotics, according to which they distinguish:

1. Phenothiazines, as well as other tricyclic derivatives. Among them there are such types:

   ● neuroleptics with a simple aliphatic bond (levomepromazine, alimemazine, promazine, chlorpromazine), powerfully block acetylcholine receptors and adrenoreceptors, have a pronounced sedative effect and can cause extrapyramidal disorders;
   ● antipsychotics with a piperidine core (thioridazine, pipothiazine, periciazine), which have a moderate antipsychotic effect and mild neudocrine and extrapyramidal side effects;
   ● Antipsychotics with a piperazine core (fluphenazine, prochlorperazine, perphenazine, thioproperazine, frenolone, trifluoperazine) are able to block dopamine receptors, and also have little effect on acetylcholine and adrenoreceptors.

2. All thioxanthene derivatives (chlorprothixene, flupentixol, zuclopenthixol), whose action is similar to that of phenothiazines.
3. Substituted benzamides (tiapride, sultopride, sulpiride, amisulpride), the action of which is also similar to phenothiazine antipsychotics.
4. All derivatives of butyrophenone (trifluperidol, droperidol, haloperiodol, benperidol).
5. Dibenzodiazapine and its derivatives (olanzapine, clozapine, quetiapine).
6. Benzisoxazole and its derivatives (risperidone).
7. Benzisothiazolylpiperazine and its derivatives (ziprasidone).
8. Indole and its derivatives (sertindole, dicarbine).
9. Piperazinylquinolinone (aripiprazole).

Of all the above, it is possible to distinguish available antipsychotics - drugs sold without prescription in pharmacies, and a group of antipsychotics that are sold strictly according to the doctor's prescription.

Interactions of neuroleptics with other drugs

Most often, these symptoms appear when the neuroleptic is withdrawn (this is also called "withdrawal syndrome"). The withdrawal syndrome has several varieties: hypersensitivity psychoses, unmasked dyskinesia (or recoil dyskinesia), cholinergic "recoil" syndrome, etc.

To prevent this syndrome, treatment with antipsychotics must be completed gradually, gradually reducing the dose.

When taking antipsychotics in high doses, a side effect such as neuroleptic deficient syndrome is noted. According to anecdotal evidence, this effect occurs in 80% of patients taking typical antipsychotics.

Structural changes in the brain with prolonged use

According to placebo-controlled studies of macaques given normal doses of olanzapine or haloperidol for two years, neuroleptics reduce brain volume and weight by an average of 8-11%. This is due to a decrease in the volume of white and gray matter. Recovery after neuroleptics is impossible.

After the publication of the results, researchers were accused of not testing the effects of antipsychotics on animals before entering the pharmaceutical market, and that they pose a danger to humans.

One of the researchers, Nancy Andreasen, is sure that the decrease in the volume of gray matter and the use of antipsychotics in general negatively affect the human body and lead to atrophy of the prefrontal cortex. On the other hand, she also noted that antipsychotics are important medicine, able to cure many ailments, but they need to be taken only in very small quantities.

In 2010, researchers J. Leo and J. Monkrieff published a review of research based on magnetic resonance imaging of the brain. The study was carried out to compare brain changes patients taking antipsychotics and patients not taking them.

In 14 out of 26 cases (in patients taking antipsychotics), a decrease in brain volume, gray and white matter volume was observed.

Of the 21 cases (in patients who did not take antipsychotics or took them, but in small doses), none showed any changes.

In 2011, the same researcher Nancy Andreasen published the results of a study in which she found changes in brain volume in 211 patients who took enough antipsychotics. for a long time(more than 7 years). At the same time, the larger the dose of drugs, the more significantly the volume of the brain decreased.

Development of new drugs

On the this moment new antipsychotics are being developed that would not affect receptors. One group of researchers claimed that cannabidiol, a component of cannabis, has an antipsychotic effect. So it is possible that soon we will see this substance on the shelves of pharmacies.

Conclusion

We hope no one has any questions left about what a neuroleptic is. What is it, what is its mechanism of action and the consequences of taking it, we discussed above. It remains only to add that whatever the level of medicine in modern world, no substance can be fully explored. And the trick can be expected from anything, and even more so from such complex drugs as antipsychotics.

AT recent times cases of treatment of depression with antipsychotics have become more frequent. Out of ignorance of the dangers of this drug, people make things worse for themselves. Antipsychotics should never be used for any purpose other than their intended use. And what effect these drugs produce on the brain is out of the question.

That is why neuroleptics - drugs available for purchase without prescriptions, should be used with caution (and only if you are 100% sure that you need it), and even better not to use at all without a doctor's prescription.

Antipsychotics are a large group of medications used in the treatment of mental disorders. Doctors often refer to them as antipsychotics because their greatest value lies in fighting psychosis. Many antipsychotics have a large number of contraindications, so they can only be used as prescribed by a doctor.

Classification

All antipsychotics are classified into 2 groups:

Typical neuroleptics have a stronger antipsychotic effect, but they can cause unwanted effects. These medicines only work on positive symptoms. They can significantly impair the patient's quality of life, cause depression, and worsen cognitive functions.

Atypical antipsychotics have a fairly pronounced antipsychotic effect. They practically do not cause adreno- and anticholinergic effects, have therapeutic effect to positive and negative symptoms. Atypical antipsychotics are better tolerated by patients, improve their emotional condition, cognitive functions and quality of life. In addition, they can be used in the treatment of children.

Depending on the clinical impact, antipsychotics are divided into 3 types:

• antipsychotic;
• sedatives;
• stimulating.

According to the duration of exposure, antipsychotics are divided into short-acting drugs and long-acting drugs.

Typical antipsychotics

The first antipsychotic drug is Aminazin. It has a general antipsychotic effect and is used to treat delusional and hallucinatory disorders. With prolonged use, it can cause depression and parkinson-like disorders.

Patients with neurotic and anxiety disorders, also with a phobic syndrome, a typical neuroleptic Propazine is prescribed. It has a sedative and anti-anxiety effect. Unlike Aminazine, Propazine is useless for hallucinations and delusional disorders.

Tizercin has a more pronounced anti-anxiety effect. It is used to treat affective-delusional disorders and. In small doses, it has a hypnotic effect.

Note! Most typical neuroleptics are available in the form of tablets and solution for intramuscular injection. Maximum daily dosage for oral use - 300 mg.

Atypical antipsychotics

In 1968, the drug of atypical structure Sulpiride was synthesized for the first time. It is used to treat Briquet's syndrome, hypochondriacal and senestopathic syndromes. The drug is effective in serious behavioral disorders in children over 6 years of age, especially in autistic syndrome.

If a patient is diagnosed with a hallucinatory-delusional disorder, then he is prescribed the atypical antipsychotic Solian. It is similar in action to Sulpiride, effective for the treatment of apathetic manifestations and conditions with hypobulia.

most popular atypical antipsychotic considered the drug Risperidone. It is prescribed to patients with psychosis, symptoms of hallucinatory-delusional disorders, obsessive states.

Quite often, with catatonic syndromes, the drug Clozapine is used. It has a sedative effect and, unlike Aminazine, does not cause depression.

Indications

Antipsychotics have the following indications for use:

• psychosis;
• schizophrenia;
• depressive state;
• bipolar disorder;
• increased feeling of anxiety;
• anxiety and panic.

Antipsychotics are prescribed for chronic insomnia, phobias, mood swings and hallucinations.

Mechanism of action

Antipsychotics have appeared relatively recently. Before their discovery in psychiatry, experts used poisonous and narcotic plants, injected bromides intravenously, and used coma therapy. In the 1950s, patients with psychosis began to be prescribed drugs. A few years later, first-generation antipsychotics appeared. Such drugs differ in the following pharmacological effects:

1. Helps to lower body temperature.
2. Provide antiemetic action.
3. They have a sedative effect.
4. They have a tranquilizing effect.
5. Normalize human behavior.
6. Reduce vegetative reactions.
7. They have a hypotensive effect.
8. Enhance the effects of alcohol narcotic analgesics, sleeping pills and tranquilizers.

The mechanism of action of drugs is aimed at reducing the speed of transmission of brain impulses. They inhibit the substance dopamine, which transmits impulses in some brain cells. Most antipsychotics are rapidly destroyed and easily excreted from the body.

Quite often, doctors prescribe prolonged medications. They are able to have a therapeutic effect lasting up to 30 days. These drugs include Haloperidol decanoate and Klopiksol-depot. The advantage of long-acting drugs is ease of use, but they are typical neuroleptics, therefore they are inferior in safety to most atypical antipsychotics.

Contraindications

Antipsychotics are contraindicated in such cases:

• individual intolerance;
• violation of the liver or kidneys;
• Availability ;
• pregnancy and lactation;
• chronic cardiac pathologies;
• fever;
• coma.

Side effects

The likelihood of side effects depends on several factors:

• dosage used;
• patient's age;
• his state of health;
• interaction of antipsychotics with other drugs that the patient is taking.

Antipsychotics can cause a number of side effects:

• increased drowsiness;
• neuroleptic syndrome;
• loss of appetite;
• increase or decrease in body weight.

At neuroleptic syndrome the patient may be disturbed slight dizziness, weakness, drowsiness and dry mouth. After the onset of symptoms, a person falls into a dream and may be in a state of dormancy for more than 24 hours. It is very easy to wake him up, but he falls asleep again. With neuroleptic malignant syndrome, additional symptoms may occur:

• constriction of the pupils;
• decrease in body temperature;
• blanching of the skin;
• tremor in the limbs;
• a sudden attack of anxiety;
• impaired coordination of movements.

Often, doctors note convulsions and disorders respiratory system, which is due negative influence Aminazina.

Note! To remove the drug from the body, gastric lavage is required. It should be carried out as soon as possible so that there are no problems with gastrointestinal tract. Then the specialist prescribes oxygen therapy.

The use of neuroleptics

Reception of neuroleptics can be carried out as follows:

1. Fast method. The dosage is brought to the optimum for 1-2 days, then remains unchanged until the end of the course of treatment.
2. Slow growth. The attending physician increases the dose of the drug gradually. After she keeps on optimal level the entire therapeutic period.
3. zigzag method. The patient accepts medicine high dosages, then sharply reduces, and then again increases. Thus, the entire course of treatment lasts.
4. Treatment of medications with interruptions of 5-6 days.
5. Shock therapy. The patient takes the drug 2 times a week in very large dosages. As a result of therapy, the body experiences chemoshock, and psychoses disappear.
6. alternating method. The scheme involves taking various psychotropic drugs.

1. Benzodiazepines. In combination with antipsychotics, they can cause respiratory depression.
2. Antihistamines. Lead to failure of the central nervous system.
3. Insulin and antidiabetic drugs reduce the effectiveness of antipsychotics.
4. Tetracyclines. Increase the risk of liver damage by toxins.

Antipsychotics take an average of 6 weeks. In some cases, in order to achieve sustainable positive result longer therapy may be required. In some patients, treatment lasts a lifetime with short breaks.

Cancellation of drugs

After stopping antipsychotic treatment, the patient's condition may worsen. Antipsychotic withdrawal syndrome appears almost immediately. It lasts up to 14 days. To alleviate the patient's condition, the doctor can transfer him from antipsychotics to tranquilizers. In addition, he prescribes B vitamins.

Antipsychotics available without prescription

You can buy the following antipsychotics at a pharmacy without a doctor's prescription:

• ariprizol;
• olanzapine;
• Serdolect;
• Chloprothixene;
• Etaperazine.

Antipsychotics of a new generation without side effects

The most effective and safe are atypical antipsychotics of the new generation. This group includes:

• Betamax;
• Depral;
• Zeldox;
• Clozapine;
• Lakvel;
• Limipranil;
• Prosulpin;
• Solian;
• Sertindole and others.

Modern antipsychotics have a sedative and hypnotic effect, reduce, clarify the thought process and relieve muscle tension.

Top 5 Best Antipsychotics

The list of the most popular neuroleptics includes such drugs:

• Abilify;
• Quetiapine;
• Levomepromazine;
• fluphenazine;
• Fluanxol.

Abilify

The active ingredient in Abilify is aripiprazole. The drug has the following indications:

• acute attacks of schizophrenia;
• schizophrenia of any kind;
• acute manic disorders.

Abilify is contraindicated in patients under 18 years of age and people with hypersensitivity to the components of the drug.

Quetiapine

It is considered the safest atypical antipsychotic. The drug is prescribed for the treatment of schizophrenia and manic episodes in bipolar disorders. Unlike other antipsychotics, Quetiapine does not cause anticholinergic side effects and hyperprolactinemia. Side effects can only occur with an overdose. These include dizziness, drowsiness and depression.

Levomepromazine

It has an anti-anxiety effect and is more powerful tool unlike Aminazina. The drug is prescribed for psychomotor agitation, paranoid-hallucinatory syndromes and for complex therapy patients with and oligophrenia.

fluphenazine

It is one of the best antipsychotics, which relieves irritability and has a significant psychoactivating effect. The drug is prescribed for neuroses and hallucinatory disorders. It is injected into the gluteal muscle at a dosage of 12.5 mg or 0.5 ml for adult patients and 6.25 or 0.25 ml for the elderly.

Nuance! Fluphenazine should not be combined with other sedative drugs, alcohol and narcotic analgesics.

Fluanxol

It has an anxiolytic and antipsychotic effect. It is used to treat psychosis, thought disorders and hallucinations. In addition, Fluanxol is prescribed for the syndrome. The drug weakens secondary mood disorders, alleviates social adaptation and improve patient communication.

When treating with neuroleptics, the patient must follow a few simple rules:

1. Do not exceed the dosage and frequency of taking the medicine indicated by the doctor.
2. Avoid all alcoholic beverages.
3. Eat well, include in the diet foods enriched with protein and vitamins.
4. Refuse to drive a car and other mechanisms, since antipsychotics slow down the reaction rate.
5. Drink plenty of fluids, while limiting your intake of coffee and strong tea.
6. Do gymnastics in the morning.
7. When adverse reactions immediately seek help from a doctor.