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治療學編輯

  • Patients who have had two or more schizophrenic episodes should receive maintenance therapy for at least five years, Low dose of antipsychotic drugs are not as effective as higher-dose maintenance therapy in preventing relapse.

分類 (機轉) 編輯

  • 大部分的抗精神病藥都會同時阻斷M、α、D1、D2、H1接受體,但主要作用是阻斷D2接受體,而有精神安定作用。除了D2之外的其他接受體作用就成了不可獲免的副作用。
  • 但是typical neuroleptics主要的副作用是錐體外症候群;而atypical neuroleptics則無此負作用。
  • 其中typical neuroleptics又分成low pottency和high pottency。
  • As a result, The actions of the neuroleptic drugs are antagonized by agents that raise the dopamine concentration -for example, levodopa and amphetamines.
  • The newer atypical agents appear to exert part of their unique action through inhibition of serotonin receptors (5-HT)-5-HT2A autoreceptors.

分類(化學結構) 編輯

  • Phenothiazines
    • Propylamine side-chain
    • Piperidine side-chain
    • Piperazine side-chain
  • Phenothiazines-likes
    • Thioxanthenes
    • Dibenzothiazepines
    • Dibenzoxazepines
    • Dibenzodiazepines
    • Thienobenzodiazepines
  • Fluorobutyrophenones
  • β-Aminoketones
  • Benzamides
  • Antimanic agents

個論 編輯

Phenothiazines 編輯

Propylamine side-chain 編輯

Piperidine side-chain 編輯

Piperazine side-chain 編輯

Phenothiazines-likes 編輯

Thioxanthenes 編輯

Dibenzothiazepines 編輯

Dibenzoxazepines 編輯

Dibenzodiazepines 編輯

Thienobenzodiazepines 編輯

Fluorobutyrophenones 編輯

β-Aminoketones 編輯

Benzamides 編輯

Antimanic agents 編輯

分類編輯

TIPICAL編輯

弱效編輯


強效編輯

ATYPICAL編輯

抗精神病藥的其他功能編輯

腸胃道作用編輯

  • Be useful in the treatment of drug-induced nausea.尤其是prochlorperazine
  • antiemetic effects:With the exception of thioridazine most of the neuroleptic drugs have antiemetic effects that are mediated by blocking D2-dopaminergic receptors of the chemoreceptor trigger zone of the medulla.

治療慢性神經痛編輯

  • Neuroleptics are used in combination with narcotic analgesics for treatment of chronic pain with severe anxiety.

其他編輯

副作用編輯

  • In the pituitary, neuroleptics block D2 receptors, leading to an increase in prolactin release.
  • Blockade of α -adrenergic receptors causes lowered blood pressure, orthostatic hypotension and light-headedness
  • Antimuscarinic effects:The neuroleptics often produce dry mouth, urinary retention, constipation, and loss of accommodation.
  • Sedation occurs in those drugs that are potent antagonists of the H1 histamine receptor, including chlorpromazine and clozapine.
  • Drowsiness occurs due to CNS depression, usually during the first two weeks of treatment.
  • Confusion is sometimes encountered.
  • The neuroleptics depress the hypothalamus, causing amenorrhea, galactorrhea, infertility, and impotence.
  • The neuroleptics also alter temperature-regulating mechanisms and can produce pikilothermia (body temperature varies with the environment).


毒性編輯

  • Neuroleptic malignant syndrome:This potentially fatal reaction to neuroleptic drugs is characterized by muscle rigidity, fever, stupor, unstable blood pressure, and myoglobinemia. Treatment necessitates discontinuation of the neuroleptic and Administration of dantrolene or bromocriptine may be helpful.


藥物連用的結果編輯

Cautions and contraindications編輯

  • Acute agitation accompanying withdrawal from alcohol or other drugs may be aggravated by the neuroleptics. Stabilization with a simple sedative, such as a benzodiazepine, is the preferred treatment.
  • Chlorpromazine and clozapine are contraindicated in patients with seizure disorders, because these drugs can lower seizure threshold. The neuroleptics can also aggravate epilepsy.


相關條目編輯

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