Dorothy FarrarNeuroleptics
Neuroleptics are mainly used against psychoses. The first neuroleptics were developed in the 1950s. A whole new generation of this group of drugs is now available to curb or prevent psychotic flare-ups.
What are neuroleptics?
Another name for neuroleptics is antipsychotics. According to the current state of research, the cause of psychotic flare-ups is suspected to be a disrupted brain metabolism. As a result, the release of the neurotransmitter dopamine in particular is out of balance. Neuroleptics influence the dopamine metabolism in the synaptic gaps between the nerve cells. Dopamine is a messenger substance that transmits information from cell to cell.
A disturbance in this area can cause schizophrenic symptoms, for example . For this reason, accompanying psychotic phenomena such as delusions and hallucinations can often (but not always) be curbed with neuroleptics. Various drugs often have to be tested before the right neuroleptic is identified in the individual case. This is due to the fact that the mode of action of neuroleptics is still partly unexplored. The various antipsychotics dock to different dopamine receptors in the brain . Since it is not possible to say exactly which receptors are affected in individual cases, drugs must first be checked for their effect.
Effect and medical application
Neuroleptics have an antipsychotic effect on the one hand and a sedative effect on the other. In many cases, psychotic symptoms, such as those associated with mania or schizophrenia, subside after a few weeks if the right neuroleptic has been administered. Long-term use of these drugs can also prevent relapses. However, neuroleptics are now no longer used only to combat psychosis.
Due to their sedative effect, they are often used in old people’s homes for calming, personality disorders , obsessive-compulsive disorders, depression and behavioral disorders in autism . Although it is known that neuroleptics have an effect on dopamine metabolism (some also affect norepinephrine ), it has not yet been fully researched how exactly they work. For this reason, the range of applications has expanded significantly in the meantime.
shapes and groups
A distinction is made between typical and atypical neuroleptics. Typical neuroleptics are older generation drugs, but are now prescribed much less frequently due to the fact that they have increased the risk of extrapyramidal syndromes (movement disorders similar to those of Parkinson’s disease ). Representatives of the older generation are, for example, chlorpromazine (Thorazine®), haloperidol (Haldol®) or perazine (Taxilan®).
According to comparative studies, atypical neuroleptics cause significantly fewer extrapyramidal syndromes, which is why they have replaced typical neuroleptics as the drug of first choice. However , some of the newer generations of drugs cause other serious side effects such as severe weight gain . Representatives of the newer generations are, for example, amisulpride (Solian®), risperidone (Risperdal®), olanzapine (Zyprexa®) or quetiapine (Seroquel®).
Neuroleptics are also differentiated according to their potency: Accordingly, there are low-potency antipsychotics, which primarily have a sedating effect, medium-potency and high-potency neuroleptics. For example, the low-potency promethazine (Atosil®) has a predominantly sedative effect, while the haloperidol (Haldol®) is highly potent, which, although it belongs to the older generation, is still frequently used due to its strong antipsychotic effect.
dosage
Dosages will vary depending on the potency of the neuroleptic and the individual’s individual needs. While some drugs only require a few milligrams of the active ingredient to have an effect, other antipsychotics require significantly more to be effective. As a rule, an acute attack is treated with a higher dose, while maintenance doses are significantly lower.
In the meantime, we know that neuroleptics should be dosed as low as possible in order to avoid serious side effects. In earlier decades, significantly higher doses were used in psychiatric practice. If a drug is to be discontinued, experts speak of a “tapering off”, which means that the antipsychotic must be slowly reduced. Discontinuation abruptly can trigger so-called withdrawal psychoses.
Herbal, natural and pharmaceutical alternatives
Neuroleptics are the drugs of first choice for psychoses. There are basically no herbal, natural and pharmaceutical alternatives. However, herbal active ingredients are available to intercept states of excitement associated with psychoses . Often, however, herbal remedies such as valerian are too weak to curb restlessness . However, it has been proven that exercise can help to reduce or stop taking medication over the long term.
In addition, those affected are dependent on a good daily structure and a helpful social environment. However, successful psychotherapy can also have a positive effect on the clinical picture, so lower doses may be sufficient. However, if an affected person is in an acute stage, these alternatives will not help at first. Rather, they are long-term options to bring about a permanent improvement after a basic stabilization.
Interactions and side effects
The side effects of neuroleptics are sometimes significant. While representatives of the older generation cause extrapyramidal syndromes, atypical neuroleptics often lead to increased appetite , weight gain, impaired sexual function or hormonal imbalances . In addition, the consumption of alcohol and sedatives should be avoided during the duration of the intake , as this can lead to an undesirable increase in the effects.
A so-called malignant neuroleptic syndrome occurs very rarely, but it can be life-threatening. This is characterized by paleness, sweating and dizziness . In this case, medical intervention is absolutely necessary. Many patients who take neuroleptics have to pay attention to their diet and get enough exercise to avoid the side effects of weight gain such as diabetes or high blood pressure .
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.