Antipsychotic drugs antipsychotics sedatives

If sedatives, barbiturates, antipsychotic drugs, stimulants, opiates and thyroid medications all outperform inert placebos in the treatment of depression, does this mean that any active drug can function as an antidepressant Apparently not. In September 1998 the pharmaceutical company Merck announced the discovery of a novel antidepressant with a completely different mode of action than other medications for depression. This new drug, which they later marketed under the trade name Emend for the prevention of nausea and vomiting due to chemotherapy, seemed to show considerable promise as an antidepressant in... 

Most antipsychotic drug interactions are relatively minor and often involve additive CNS, ACh, or sedative effects. 

The neuroleptic droperidol possesses antipsychotic, sedative, and antishock action. It potentiates the action of drugs for narcosis. In psychiatric practice, droperidol is used for psy-chomotor excitement and hallucinations. The principal use of this drug lies in anesthesiology for neuroleptanalgesia in combination with fentanyl. It is used in premedication as well as in surgical operations and post-operational circumstances. Synonyms of this drug are talam-onal, droleptan, leptofen, innovar, and others. 

Antipsychotic drugs with strong sedative clinical effects (e.g. chlorpromazine. clozapine, olanzapine) produce subjective and objective sedation and impair most areas of performance in healthy volunteers, usually at doses far below those typically used in patients. Antipsychotic drugs with little sedative clinical action (e.g. pimozide, sulpiride, amisulpride) produce few subjective and objective effects in healthy... 

Taken with alcohol they potentiate the sedative effects and impairment of psychomotor performance. Hepatic enzyme induction by barbiturates or nicotine may reduce plasma levels. Cimetidine may increase levels by enzyme inhi bition. Some antipsychotic drugs may compete for similar metabolic pathways. 

Most antipsychotic drugs cause unpleasant subjective effects in nonpsychotic individuals. The mild to severe EPS, including akathisia, sleepiness, restlessness, and autonomic effects are unlike any associated with more familiar sedatives or hypnotics. Nevertheless, low doses of some of these drugs, particularly quetiapine, are used to promote sleep onset and maintenance, although there is no approved indication for such usage. 

Other indications for the use of antipsychotics include Tourette s syndrome, disturbed behavior in patients with Alzheimer s disease, and, with antidepressants, psychotic depression. Antipsychotics are not indicated for the treatment of various withdrawal syndromes, eg, opioid withdrawal. In small doses, antipsychotic drugs have been promoted (wrongly) for the relief of anxiety associated with minor emotional disorders. The antianxiety sedatives (see Chapter 22) are preferred in terms of both safety and acceptability to patients. 

Antipsychotics have varying degrees of sedative properties. Contrary to previous beliefs, sedative properties do not enhance the antipsychotic efficacy of these drugs. Consequently, sedative side effects offer no benefit and can be detrimental in withdrawn psychotic patients. 

In the 1950s, a more evidence-based approach to antipsychotic drug (AP) therapy was undertaken when structural variations of antihistamines were produced by a French scientist (Paul Charpentier), in order to make use of the unwanted sedative side effect produced by these drugs. Initially used to lower body temperature in patients undergoing cardiac surgery, chlorpromazine (Fig. II) was the first drug with antipsychotic properties successfully used in clinical trials [3],... 

Barbiturate overdose may be treated with gastric lavage and oral administration of activated charcoal. Supportive therapy of cardiovascular, respiratory, and renal function also should be provided. Coadministration of alcohol and barbiturates may increase the sedative effect of chloral hydrate. Long-term use of barbiturates leads to dependence. Sudden discontinuation of an antipsychotic drug may cause withdrawal symptoms such as nausea, vomiting, anorexia, diarrhea, rhinorrhea, sweating, insomnia, restlessness, and vertigo.151... 

It is not clear that so-called antipsychotic drugs are superior to other types of drugs with sedative effects but different mechanisms of action. Lithium, benzodiazepines and opium have been shown to be comparable to neuroleptics in the treatment of psychotic states in some studies. The ability of the neuroleptic drugs to reduce the most characteristic symptoms of psychosis such as hallucinations, delusions and thought disorder have often been interpreted as evidence of their specifically antipsychotic or antischizophrenic action (The National Institute of Mental Health Psychopharmacology Service Center Collaborative Study... 

Antihistamines are to varying degrees sedative, the more sedating members ( older antihistamines ) of the class interacting with other sedating drugs (antipsychotics, BZDs, opioids,barbiturates). 

Numerous systemic drugs have been implicated, including the penicillins and sulfonamides, which can cause swelling of the lids and conjunctiva as part of a generalized urticaria or localized angioneurotic edema. Other drugs implicated in ocular allergic reactions are antidepressants, antipsychotics, antihypertensives, antirheumatics, sedatives, and hypnotics. 

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