Psychotropic drugs

Psychotropic medicines - group medicinal substances affecting mental processes, affecting mainly on higher nervous activity. Psychotropic drugs are classified by clinical effect and are divided into three groups: 1) neuroleptic drugs (see), 2) antidepressants (see), 3) psychotomimetics funds (see).
Mental disorder, accompanied by delusions, hallucinations, intense anxiety or fear, and the state with a predominance of excitation - catatonic, manic, States of altered consciousness, and so on are treated mainly neuroleptics. Mental disorder, manifested inhibition,first of all different depressive syndromes - treated with antidepressants.
Because a significant number of mental disorders usually combines the effects of excitation and brakingin practice often use a combined treatment with neuroleptics and antidepressants. Dose ratio change depending on changes in mental status of the patient.
It must be remembered that during treatment with psychotropic drugs mentally ill used doses considerably exceed the highest daily dose of psychotropic substances listed in the Pharmacopoeia.
Psychotropic drugs often have side effects, in some cases so severe that they have to stop treatment and use medicines that treat developed complications.
Side effects occurring most commonly during the first two to four weeks after the start of treatment.
Vegetative disorders: dry mouth or increased allocation of saliva; skin dryness or, on the contrary, increased sweating; nausea, constipation, diarrhea; decreased or increased body temperature; low blood pressure; increased or decrease heart rate; sharp narrowing or dilated pupils; urination disorders.
Most of these disorders disappear of themselves. Blood pressure lowering easily leads to a sharp drop in blood pressure when standing up from a lying position, so the first weeks of treatment with psychotropic drugs should avoid sudden changes in body position and to stay in bed for one hour after taking the medicine.
The long delay urination produce catheterization of the bladder, and treatment is temporarily cancelled.
Endocrine disorders manifested by the menstrual cycle and lactorea women; reduction of potency in men. These phenomena special treatment is not required. Rare disorder of the thyroid gland or disorder in the form of the syndrome Itsenko - Kushinga (see Itsenko - Kushinga disease) require stopping treatment.
Disorders of liver function. Manifested by headache, nausea, vomiting, pains in the liver. In blood serum increases the content of bilirubin. You must immediately discontinue treatment with psychotropic drugs, as may develop acute yellow atrophy of the liver.
Leukopenia and agranulocytosis. Found most frequently in women. Develop gradually. The fall in the number of cells below 3500 with the simultaneous disappearance of granulocytes demands the immediate cessation of treatment with psychotropic drugs.
Side effects that appear at different times after the start of treatment.
Allergic phenomena occur more often as dermatitis - eczema, akzente, erythema, urticaria. Less likely to cause angioedema, allergic conjunctivitis, allergic arthritis. Skin allergic dermatitis can occur more frequently with the additional effect of ultraviolet light. Therefore patients during treatment with psychotropic drugs are not recommended to be in the sun.
Neurological disorders can occur akineticalkie syndrome (see Parkinsonism), or various hyperkinesia (see) - isolated, generalized resembling horey (see). In elderly patients often oral hyperkinesis - makaysia and sucking movement with his lips, involuntary contraction of the masticatory muscles. Sometimes there cramp eyes. To prevent the development of neurological disorders usually at the beginning of treatment with psychotropic drugs prescribed antiparkinsonian funds. Appearance during treatment with psychotropic drugs thrombosis and embolism requires the immediate cessation of treatment.
Convulsive attacks that appear despite the use of anticonvulsant drugs require discontinuation of treatment with psychotropic drugs.
Mental disorders. Most often found in the form of akathisia, i.e., anxiety, followed by the need for the movement, and in the night of sleep disorders.
Significantly less likely to develop the illness-various manifestations of the state of stupefaction consciousness, depression, passing hallucinatory and delusional-delusional disorder.
Contraindications to the use of psychotropic drugs are diseases of the liver, kidneys, stomach ulcers and duodenal ulcers, severe hypertension and atherosclerosis, allergic diseases, diabetes, blood diseases, organic diseases of the Central nervous system.

Psychotropic drugs (gr. psyche-the soul, the spiritual qualities; tropos - direction) - a group of drugs that affect mental processes by predominant influence on higher nervous activity.
General principles of classification
Since 1950, after synthesizing of largactil (synonym: chlorpromazine, chlorpromazine) psychotropic drugs quickly found application in psychiatric practice. Has developed a new section pharmacology - psychopharmacology (see). To date, there are more than 150 psychotropic substances, distinguished by his action and belonging to the most different groups of chemical compounds.
In a basis of classification of psychotropic drugs currently expected clinical drug.
Psychotropic drugs are divided into three large groups: 1) soothing, sedative action (synonym: tranquilizers, neuroleptics, neurologica, psycholeptic); 2) the exciting, stimulating action (synonym: antidepressants, analeptiki, Pechatniki) and 3) the means that cause mental disorders (synonym: hallucinogens, psychotomimetic, psychodysleptics substances). This division is relative, since many psychotropic drugs have different effects, depending on the peculiarities of psychopathological condition, dosage, duration of use and other reasons; there are also psychotropic substances of the mixed action.
Drugs each of these groups differ in the intensity of the action (at equivalent doses). Some of them are able to resolve hallucinations, delirium, catatonic disorder and have antipsychotic action, others have only a General calming effect. In this regard, the group of neurological (neuroleptics) are divided into "big" and "small" tranquilizers. Similarly, you can talk about "big" and "small" antidepressants.

Characteristic of the drugs
In psychiatric practice often used doses exceeding the dose, indicated in Pharmacopoeia, many times. They indicated in the present article as the maximum.
Large tranquilizers. The most common big tranquilizers (list compiled in the order of diminishing power of action within each chemical group) include the following drugs (in parentheses are synonyms):
Derivatives fenotiazina
1. Megatel (tioproperazina, tioproperazina, cooperatin, sulfamethazine, actin, Ventil, zevalin). The usual daily dose of 5-60 mg; max - 200 mg
2. Liegen (fluphenazine, ftorfenazin, flumadin, prolixin, permitil, seminal, moditen). The usual daily dose is 5-10 mg; maximum of 20 mg.
3. Triftazin (see) (stelazine, trifluoperazine, trifluoromethylphenyl, terluin, Assasin, escasany, aeronaval). The usual daily dose of 5-40 mg; max - 100 mg
4. Chlorpromazine (see) (chlorpromazine, largactil, pregomisin, MegaFon, torasin, hibernal, Contamines, fraktil). The usual daily dose is 25 -600 mg; maximum - 1000 mg.
5. Levomepromazine (nozinan, methoxycoumarin, metotrimeprazin, sinagan, varactyl, deoran, naroll, Naranjal, newsin, Nirvan, tizertsin). The usual daily dose of 25-400 mg; max-800 mg.
6. Stemetil (timentin, meterin, compazine, prochlorperazine, prochlorperazine, nor is filed, dikopol, Norimin). The usual daily dose of 20 to 100 mg; max,-200 mg.
7. Dartel (gartlan, thiopropazate). The usual daily dose of 5-60 mg; max - 100 mg
8. Phrenolon. The usual daily dose of 30 to 60 mg; max allowed is 100 mg
9. Etaperazin (see) (trilafon, perphenazine, dezenten, chlorphenesin, fentazin, flociprin). The usual daily dose of 10-120 mg; maximum of 300 mg
10. Melleril (mellaril, Mallory, thioridazine). The usual daily dose of 75 - 400 mg; max,-1000 mg.
I. Maasin (see) (pecanin, palatal, Paktel, racumin). The usual daily dose 25-350 mg; max - 700 mg
12. Propazin (see) (promisin, Spain, werfen, tamofen, alien, lirael, nevrologii, protectis, pruzin, seistan, contractile). The usual daily dose of 25-800 mg; max - 2000 mg
13. Promethazine (see) (protein, promethazine, Praslin, atosil, Farhan, phenergan, prozit, proteinemia, targan, Tandil, allergen, hiberno-Legian). The usual daily dose is 150 to 200 mg; maximum of 300 mg

Rauwolfia alkaloids
1. Reserpine (see) (raunatin, serpasil, serpin, sedrawan, serpilot, serfin, serpasil, sandal, reunanen, Runova, reused, rousselin, rezerpin, reserves, Revzin, rexinoid, Quintin, christotherapy, accuser). The usual daily dose of 0.25 to 15 mg; maximum-50 mg
2. Deserpidine (harmony, cenestin, renormin, reconnecting). The usual daily dose of 0.25-5 mg; max - 10 mg.

Derivatives butyrophenones
1. Tripeedo. The usual daily dose of 1.5-2 mg; max - 6,5 mg
2. Haloperidol (haloperidol, Haldol, serenas). The usual daily dose is 3 - 10 mg; maximum of 20 mg.
3. Galvanize (sealant). The usual daily dose of 75-130 mg; max - 320 mg

Derivatives of tioksantena
Taractan (truxal, Fraxel, chlorprothixene, protiksan, tioksantena, Tarzan). The usual daily dose is 50 to 500 mg; maximum-1000 mg.


                      Minor tranquilizers
The most commonly used small tranquilizers (partly, this small antidepressants) include the following medications.

Derivatives of benzodiazepine
1. Librium (Elenium, chlordiazepoxide, methaminodiazepoxide). Usual dose - 5-30 mg; max - 100 mg
2. Valium (diazepam). The usual daily dose of 10-40 mg; max-80 mg.

Derivatives glycol or glycerol
Meprobamate (see) (andaxin, meprobamate, Miltown, equanil, cadasil, tranquilin, Erbil, harmony). The usual daily dose is 200-400 mg; max - 3000 mg

Derivatives hydroxyzine
Atarax (Victorin, iterated, hydroxyzine, TRANS-Q). The usual daily dose of 25-100 mg; max of 400 mg

Derivatives benactyzine
1. Amizil (see) (Domicil, benactyzine, valladon, difenin, kapron, lucidi, nervetti, nirvachan, nominal). The usual daily dose is 8 to 12 mg; max-25 mg
2. Frenkel (azalkanov, Trenton, taractan, psihozah, calmaran). The usual daily dose of 50-200 mg; max, extra - 500 mg.
Large and small tranquilizers constitute the main group of psychotropic drugs - neurologiske funds.
More detailed pharmaco-clinical characteristics of the above drugs group - see Neurologiske funds.

Antidepressants. The most common Psychoanaleptics tools (drugs) include the following.

Derivatives amitriptyline
1. Triptizol (carotin, tryptanol, elavil, laroxyl, horizontal). The usual daily dose of 75-200 mg; max - 350 mg.
2. Nortriptyline (Eritrean, nortrilen, aventyl). The usual daily dose is 100 - 150 mg; maximum - 250 mg.

Derivatives aminobenzyl
1. Kisin (see) (imipramine, melipramine, Tofranil). The usual daily dose 25-300 mg; maximum-400 mg
2. Surmontil (trimipramine, trimipramine). The usual daily dose 25-300 mg; maximum-400 mg
Inhibitors monoaminooksidasy (MAOI) (incompatible with derivative aminobenzyl and fenotiazina; if necessary, consistent combination to pause between drugs at least 2 weeks; to exclude from the diet of patients cheese, cream, meat extracts, beer, wine!).
1. Iprase (see) (marsilia, marshaled, iproniazid). The usual daily dose• 25-150 mg; max-200 mg
2. Named (nialamid, numedal, naregal). The usual daily dose of 75-200 mg; maximum - 400 mg
3. Transamin (see) (Parnate, tranilcipromin). The usual daily dose of 5 to 30 mg; maximum - 50 mg
4. Falutin (fenelzin, nardil, Nedelin, kevadel, Stonewall). The usual daily dose of 15-75 mg; max - 150 mg.
5. Benazir (isocarboxazid, Marplan). The usual daily dose is 20-40 mg; max - 80 mg.
6. Katran (Feyzin, fenyprazin, Catanese, kevadel). The usual daily dose of 3-12 mg; max - 25 mg
7. Indepen. Usual dose - 5-20 mg; max - 30 mg
To small antidepressants are also referred rarely now used derivative of amphetamine (dexedrin, phenaminum, meth, Tinatin) and derivative diphenyl methane (perhydrol, centerin, Fendt).
As antidepressants are widely used substances attributable to neuroleptics such as nozinan, taractan, phrenolon.
Psychotomimetic. Among the substances that cause mental disorders include mescaline, lysergic acid diethylamide, psilocybin, sernyl. In clinical practice, they are not used; used for experimental psychopathology research. Cm. also Psychotomimetics funds.