phenothiazines such as chlorpromazine were the first type of
antipsychotic
health system. Its introduction has been labeled as one of the great advances in the history of psychiatry. It is available as a generic medication. The wholesale cost in the developing world is between US$0.02 and US$0.12 per day. In the United States it costs about US$2 per day. Chlorpromazine is classified as a low-potency typical antipsychotic and in the past was used in the treatment of both acute and chronic psychoses, including schizophrenia and the manic phase of bipolar disorder, as well as amphetamine-induced psychosis. Low-potency antipsychotics have more anticholinergic side effects, such as dry mouth, sedation, and constipation,
Chlorpromazine
been stable for a period of time on antipsychotics, especially in situations where the dose has not been changed and there are no issues of noncompliance or consumption of psychoactive substances known to worsen psychosis. NMS is usually caused by antipsychotic drug use, and a wide range of drugs can result in NMS. Individuals using butyrophenones (such as haloperidol and droperidol) or phenothiazines (such as promethazine and chlorpromazine) are reported to be at greatest risk. However, various atypical antipsychotics such as clozapine, olanzapine, risperidone, quetiapine, and ziprasidone have also been implicated in cases. NMS may also occur in people taking
Neuroleptic malignant syndrome
Typical antipsychotic Typical antipsychotics are a class of antipsychotic drugs first developed in the 1950s and used to treat psychosis (in particular, schizophrenia). Typical antipsychotics may also be used for the treatment of acute mania, agitation, and other conditions. The first typical antipsychotics to come into medical use were the phenothiazines, namely chlorpromazine which was discovered serendipitously. Another prominent grouping of antipsychotics are the butyrophenones, an example of which would be haloperidol. The newer, second-generation antipsychotics, also known as atypical antipsychotics, have replaced the typical antipsychotics due to the Parkinson-like side effects typicals have. Both generations of medication tend to
Typical antipsychotic
the nigrostriatal system demonstrating a dopaminergic dysregulation. A group of drugs called the phenothiazines, including antipsychotics such as chlorpromazine, has been found to antagonize dopamine binding (particularly at receptors known as D dopamine receptors) and reduce positive psychotic symptoms. This observation was subsequently extended to other antipsychotic drug classes, such as butyrophenones including haloperidol. The link was strengthened by experiments in the 1970s which suggested that the binding affinity of antipsychotic drugs for D dopamine receptors seemed to be inversely proportional to their therapeutic dose. This correlation, suggesting that receptor binding is causally related to therapeutic potency, was reported by
Dopamine hypothesis of schizophrenia
of atypicals such as clozapine and risperidone, blockade of 5HT2A receptors are thought to also account for an important part of their pharmacology. Minor chemical manipulations in the chemical structure of chlorpromazine was used to create novel antipsychotic agents such as thioridazine and fluoperazine. Minor chemical manipulations in the structure of chlorpromazine led to the first tricyclic antidepressant (TCA), imipramine (Tofranil), whose structure is iminodibenzyl (dibenzazepine) based. Imipramine was first used on agitated psychotic patients, but it was shown that in the majority of cases their condition did not improve and actually worsened slightly. However, it was noted that a
Psychopharmacology revolution
interact with chlorpromazine to produce transient metabolic encephalopathy. Other drugs that prolong the QT interval such as quinidine, verapamil, amiodarone, sotalol and methadone may also interact with chlorpromazine to produce additive QT interval prolongation. The British National Formulary recommends a gradual withdrawal when discontinuing antipsychotic treatment to avoid acute withdrawal syndrome or rapid relapse. While withdrawal symptoms can occur, there is no evidence that tolerance develops to the drug's antipsychotic effects. A person can be maintained for years on a therapeutically effective dose without any decrease in effectiveness being reported. Tolerance appears to develop to the sedating effects of chlorpromazine
Chlorpromazine
by the European Medicines Agency. Chlorpromazine has tentative benefit in animals infected with "Naegleria fowleri". Chlorpromazine Chlorpromazine (CPZ), marketed under the trade names Thorazine and Largactil among others, is an antipsychotic medication. It is primarily used to treat psychotic disorders such as schizophrenia. Other uses include the treatment of bipolar disorder, attention deficit hyperactivity disorder, nausea and vomiting, anxiety before surgery, and hiccups that do not improve following other measures. It can be given by mouth, by injection into a muscle, or into a vein. Common side effects include movement problems, sleepiness, dry mouth, low blood pressure upon standing, and
Chlorpromazine
and their activity was a pioneering example of medicinal chemistry; phenothiazine is often discussed as a prototypical example of a pharmaceutical lead structure. The term "phenothiazines" describes the largest of the five main classes of antipsychotic drugs. These drugs have antipsychotic and, often, antiemetic properties, although they may also cause severe side effects such as extrapyramidal symptoms (including akathisia and tardive dyskinesia), hyperprolactinaemia, and the rare but potentially fatal neuroleptic malignant syndrome, as well as substantial weight gain. Use of phenothiazines has been associated with antiphospholipid syndrome, but no causal relationship has been established. Phenothiazine antipsychotics are classified into three
Phenothiazine
Pierre Deniker Pierre Deniker (16 February 1917 in Paris – 17 August 1998) was involved, jointly with Jean Delay and J. M. Harl, in the introduction of chlorpromazine (Thorazine), the first antipsychotic used in the treatment of schizophrenia, in the 1950s. Thorazine had been used in surgical procedures peri-operatively as an anti-nausea medication in France. Patients were noted to be less anxious and calmer. This observation eventually led Deniker to try chlorpromazine with patients who had schizophrenia, where he observed notable improvement in symptoms. The pharmaceutical company Smith-Kline had purchased the chlorpromazine rights from Rhone-Poulenc in France and had been
Pierre Deniker
Chlorpromazine Chlorpromazine (CPZ), marketed under the trade names Thorazine and Largactil among others, is an antipsychotic medication. It is primarily used to treat psychotic disorders such as schizophrenia. Other uses include the treatment of bipolar disorder, attention deficit hyperactivity disorder, nausea and vomiting, anxiety before surgery, and hiccups that do not improve following other measures. It can be given by mouth, by injection into a muscle, or into a vein. Common side effects include movement problems, sleepiness, dry mouth, low blood pressure upon standing, and increased weight. Serious side effects may include the potentially permanent movement disorder tardive dyskinesia, neuroleptic
Chlorpromazine
when it is first administered. Tolerance also appears to develop to the extrapyramidal, parkinsonian and other neuroleptic effects, although this is debatable. A failure to notice withdrawal symptoms may be due to the relatively long half life of the drug resulting in the extremely slow excretion from the body. However, there are reports of muscular discomfort, exaggeration of psychotic symptoms and movement disorders, and difficulty sleeping when the antipsychotic drug is suddenly withdrawn, but after years of normal doses these effects are not normally seen. Chlorpromazine is a very effective antagonist of D2 dopamine receptors and similar receptors, such as
Chlorpromazine
secondary amines due to sharing more in common with them. The TCAs were developed amid the "explosive birth" of psychopharmacology in the early 1950s. The story begins with the synthesis of chlorpromazine in December 1950 by Rhône-Poulenc's chief chemist, Paul Charpentier, from synthetic antihistamines developed by Rhône-Poulenc in the 1940s. Its psychiatric effects were first noticed at a hospital in Paris in 1952. The first widely used psychiatric drug, by 1955 it was already generating significant revenue as an antipsychotic. Research chemists quickly began to explore other derivatives of chlorpromazine. The first TCA reported for the treatment of depression was
Tricyclic antidepressant
on antipsychotic drugs on glutamate receptors. By using the technique of functional neurochemical assay chlorpromazine and phenothiazine derivatives have been shown to have inhibitory effects on NMDA receptors that appeared to be mediated by action at the Zn site. It was found that there is an increase of NMDA activity at low concentrations and suppression at high concentrations of the drug. No significant difference in glutamate and glycine activity from the effects of chlorpromazine were reported. Further work will be necessary to determine if the influence in NMDA receptors by antipsychotic drugs contributes to their effectiveness. Chlorpromazine does also act
Chlorpromazine
malignant syndrome, and low white blood cell levels. In older people with psychosis as a result of dementia it may increase the risk of death. It is unclear if it is safe for use in pregnancy. Chlorpromazine is in the typical antipsychotic class. Its mechanism of action is not entirely clear but believed to be related to its ability as a dopamine antagonist. It also has anti-serotonergic and antihistaminergic properties. Chlorpromazine was discovered in 1950 and was the first antipsychotic. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a
Chlorpromazine
investigations relevant to biological bases such as biochemical, genetic, physiological, neurological, and anatomical fields. In a clinical viewpoint, the etiology of these diseases takes into account various therapies, diet, drugs, potential environmental contaminants, exercise, and adverse effects of life stressors, all of which can cause noticeable biochemical changes. Sigmund Freud initially concentrated on the biological causes of mental illness and its relationship to evident behavioral factors. His belief in biological factors lead to the concept that certain drugs, such as cocaine, had an antidepressant functionality. In the 1950s the first modern antipsychotic and antidepressant drugs were developed: chlorpromazine (Thorazine), which
Biological psychopathology
marketing it as an anti-nausea medication. After Deniker's observations, they sought and received FDA approval in 1954 to market Thorazine for the treatment of schizophrenia. Pierre Deniker Pierre Deniker (16 February 1917 in Paris – 17 August 1998) was involved, jointly with Jean Delay and J. M. Harl, in the introduction of chlorpromazine (Thorazine), the first antipsychotic used in the treatment of schizophrenia, in the 1950s. Thorazine had been used in surgical procedures peri-operatively as an anti-nausea medication in France. Patients were noted to be less anxious and calmer. This observation eventually led Deniker to try chlorpromazine with patients who
Pierre Deniker
health system. Its introduction has been labeled as one of the great advances in the history of psychiatry. It is available as a generic medication. The wholesale cost in the developing world is between US$0.02 and US$0.12 per day. In the United States it costs about US$2 per day. Chlorpromazine is classified as a low-potency typical antipsychotic and in the past was used in the treatment of both acute and chronic psychoses, including schizophrenia and the manic phase of bipolar disorder, as well as amphetamine-induced psychosis. Low-potency antipsychotics have more anticholinergic side effects, such as dry mouth, sedation, and constipation,
Chlorpromazine
representing 13 clients who allege they were forcibly injected with the drugs. In the former Soviet Union, drugs were allegedly used as a form of punishment. Haloperidol, an antipsychotic medication, was a preferred agent. It was used to induce intense restlessness and Parkinson's-type symptoms. Another antipsychotic medication, chlorpromazine, was also used to induce grogginess, sedation, and (in high doses) vegetative states. Other alleged uses of pharmacological torture included: In the United States, in a series of hearings in the fall and winter of 1977, Congressional committees drew forth disclosure of project MKULTRA, which was most active between 1953 and 1966
Pharmacological torture
of chlorpromazine marked the advent of the dopamine antagonist, or first generation antipsychotic. While clinical trials showed a high response rate for both acute psychosis and disorders with psychotic features, the side-effects were particularly harsh, which included high rates of often irreversible Parkinsonian symptoms such as tardive dyskinesia. With the advent of atypical antipsychotics (also known as second generation antipsychotics) came a dopamine antagonist with a comparable response rate but a far different, though still extensive, side-effect profile that included a lower risk of Parkinsonian symptoms but a higher risk of cardiovascular disease. Atypical antipsychotics remain the first-line treatment for
Psychosis
are associated with the drug, such as friends, locations and situations. Association networks in the brain are greatly interlinked. Psychiatrists in the early 1950s discovered that a class of drugs known as typical antipsychotics (also known as major tranquilizers), were often effective at reducing the psychotic symptoms of schizophrenia. The introduction of the first widely used antipsychotic, chlorpromazine (Thorazine), in the 1950s, led to the release of many patients with schizophrenia from institutions in the years that followed. By the 1970s researchers understood that these typical antipsychotics worked as antagonists on the D2 receptors. This realization led to the so-called
Dopamine
antipsychotics. A 2015 systematic review compared Perphenazine with other antipsychotic drugs: As a member of the phenothiazine type of antipsychotics, perphenazine shares in general all allergic and toxic side-effects of chlorpromazine. A 2015 systematic review of the data on perphenazine conducted by the Cochrane Collaboration concluded that "there were no convincing differences between perphenazine and other antipsychotics" in the incidence of adverse effects. Perphenazine causes early and late extrapyramidal side effects more often than placebo, and at a similar rate to other medium-potency antipsychotics and the atypical antipsychotic risperidone. When used for its strong antiemetic or antivertignosic effects in cases
Perphenazine
that functioned as reliable antihistamines. Henri Laborit was first using chlorpromazine to treat the anxiety of patients prior to surgery. He noted the so-called "indifference" that this agent causes and suggested that it be used on agitated psychotic patients. Chlorpromazine has H1, M1, and α1 receptor antagonist activity. This causes sedation, anticholinergic effects, as well as orthostatic hypotension. It also functions as a blocker of D2 receptors, although it is much weaker and less selective than haloperidol in this respect. Blockade of the D2 receptors is thought to underlie the antipsychotic effect of the typical antipsychotics. However, in the case
Psychopharmacology revolution
agents at α-adrenergic receptors. Furthermore, they are also among the most potent antipsychotics at histamine H1 receptors. This finding is in agreement with the pharmaceutical development of chlorpromazine and other antipsychotics as anti-histamine agents. Furthermore, the brain has a higher density of histamine H1 receptors than any body organ examined which may account for why chlorpromazine and other phenothiazine antipsychotics are as potent at these sites as the most potent classical antihistamines. In addition to influencing the neurotransmitters dopamine, serotonin, epinephrine, norepinephrine, and acetylcholine it has been reported that antipsychotic drugs could achieve glutamanergic effects. This mechanism involves direct effects
Chlorpromazine
this effect. Chlorpromazine acts as an antagonist (blocking agent) on different postsynaptic and presynaptic receptors: The presumed effectiveness of the antipsychotic drugs relied on their ability to block dopamine receptors. This assumption arose from the dopamine hypothesis that maintains that both schizophrenia and bipolar disorder are a result of excessive dopamine activity. Furthermore, psychomotor stimulants like cocaine that increase dopamine levels can cause psychotic symptoms if taken in excess. Chlorpromazine and other typical antipsychotics are primarily blockers of D2 receptors. In fact an almost perfect correlation exists between the therapeutic dose of a typical antipsychotic and the drug's affinity for
Chlorpromazine
has survived the initial phase. An overdose of haloperidol can be fatal. Haloperidol is a typical butyrophenone type antipsychotic that exhibits high affinity dopamine D receptor antagonism and slow receptor dissociation kinetics. It has effects similar to the phenothiazines. The drug binds preferentially to D and α receptors at low dose (ED = 0.13 and 0.42 mg/kg, respectively), and 5-HT receptors at a higher dose (ED = 2.6 mg/kg). Given that antagonism of D receptors is more beneficial on the positive symptoms of schizophrenia and antagonism of 5-HT receptors on the negative symptoms, this characteristic underlies haloperidol's greater effect on
Haloperidol
a Nobel Prize in 1949. Between the late 1930s and early 1970s, the leucotomy was a widely accepted practice, often performed in non-sterile environments such as small outpatient clinics and patient homes. Psychosurgery remained standard practice until the discovery of antipsychotic pharmacology in the 1950s. The first clinical trial of antipsychotics (also commonly known as neuroleptics) for the treatment of psychosis took place in 1952. Chlorpromazine (brand name: Thorazine) passed clinical trials and became the first antipsychotic medication approved for the treatment of both acute and chronic psychosis. Although the mechanism of action was not discovered until 1963, the administration
Psychosis
milligrams of chlorpromazine. Agents with a chlorpromazine equivalence ranging from 5 to 10 milligrams would be considered "medium potency", and agents with 2 milligrams would be considered "high potency". Prochlorperazine (Compazine, Buccastem, Stemetil) and Pimozide (Orap) are less commonly used to treat psychotic states, and so are sometimes excluded from this classification. Where: † indicates products that have since been discontinued. Typical antipsychotic Typical antipsychotics are a class of antipsychotic drugs first developed in the 1950s and used to treat psychosis (in particular, schizophrenia). Typical antipsychotics may also be used for the treatment of acute mania, agitation, and other conditions.
Typical antipsychotic
antibacterials and on the use of biological agents for antibacterial therapy. In the 1950s new psychiatric drugs, notably the antipsychotic chlorpromazine, were designed in laboratories and slowly came into preferred use. Although often accepted as an advance in some ways, there was some opposition, due to serious adverse effects such as tardive dyskinesia. Patients often opposed psychiatry and refused or stopped taking the drugs when not subject to psychiatric control. Governments have been heavily involved in the regulation of drug development and drug sales. In the U.S., the Elixir Sulfanilamide disaster led to the establishment of the Food and Drug
Medication
In the 1950s new psychiatric drugs, notably the antipsychotic chlorpromazine, slowly came into use. Although often accepted as an advance in some ways, there was opposition, partly due to serious adverse effects such as tardive dyskinesia, and partly due their "chemical straitjacket" effect and their alleged use to control and intimidate patients. Patients often opposed psychiatry and refused or stopped taking the drugs when not subject to psychiatric control. There was also increasing opposition to the large-scale use of psychiatric hospitals and institutions, and attempts were made to develop services in the community. In 1950, Scientology was founded by L.
Anti-psychiatry
of the first antipsychotic chlorpromazine. Others such as haloperidol and trifluoperazine soon followed. It remains unclear whether the newer antipsychotics reduce the chances of developing neuroleptic malignant syndrome, a rare but serious and potentially fatal neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs. Most people on antipsychotics get side effects. People on typical antipsychotics tend to have a higher rate of extrapyramidal side effects while some atypicals are associated with considerable weight gain, diabetes, and risk of metabolic syndrome; this is most pronounced with olanzapine, while risperidone and quetiapine are also associated with weight
Management of schizophrenia
classes." "# denotes drugs that have been withdrawn worldwide." This category is for drugs that have been called both first and second-generation, depending on the literature being used. Antipsychotic drugs such as haloperidol and chlorpromazine tend to block dopamine D receptors in the dopaminergic pathways of the brain. This means that dopamine released in these pathways has less effect. Excess release of dopamine in the mesolimbic pathway has been linked to psychotic experiences. Decreased dopamine release in the prefrontal cortex, and excess dopamine release in other pathways, are associated with psychotic episodes in schizophrenia and bipolar disorder. In addition to
Antipsychotic
add up since they act on the same receptor at different sites. Convergence upon the GABA receptor is why tolerance for one drug in the group will most likely cause cross-tolerance for the other drugs in the group. However, the barbiturates are also AMPA receptor blockers, and in addition interact with the nAChR and voltage-gated calcium channels. As a result, somebody who is tolerant to benzodiazepines is more sensitive to barbiturates than vice versa. These drugs block dopamine receptors and some also block serotonin receptors (such as chlorpromazine, the first antipsychotic used clinically). Having been on one or more antipsychotics
Cross-tolerance
drugs were developed: chlorpromazine (also known as Thorazine), the first widely used antipsychotic, was synthesized in 1950, and iproniazid, one of the first antidepressants, was first synthesized in 1957. In 1959 imipramine, the first tricyclic antidepressant, was developed. Based significantly on clinical observations of the above drug results, in 1965 the seminal paper "The catecholamine hypothesis of affective disorders" was published. It articulated the "chemical imbalance" hypothesis of mental health disorders, especially depression. It formed much of the conceptual basis for the modern era in biological psychiatry. The hypothesis has been extensively revised since its advent in 1965. More recent
Biological psychiatry
inhibition, motor retardation and hypersomnia. This may be a function of the ability of MAOIs to increase synaptic levels of DA in addition to 5-HT and NE. The MAOIs also seem to be effective in the treatment of fatigue associated with fibromyalgia (FM) or chronic fatigue syndrome (CFS). Although a substantial number of MAOIs were approved in the 1960s, many of these were taken off the market as rapidly as they were introduced. The reason for this is that they were hepatotoxic and could cause jaundice. The first tricyclic antidepressant (TCA), imipramine (Tofranil), was derived from the antipsychotic drug chlorpromazine,
Serotonin–norepinephrine–dopamine reuptake inhibitor
instances of advantages to drugs that exhibit multi-receptor activity such as the anti-addictive drug ibogaine that acts within a broad range of neurohormonal systems where activity is also exhibited by drugs commonly associated with addiction including opioids, nicotine, and alcohol. Similarly chlorpromazine is primarily used as an antipsychotic, but its strong serotonin receptor blocking effects make it useful for treating serotonergic crisis such as serotonin syndrome. Dextromethorphan for its part is widely used as a cough medication, but its other actions have led to trials for several conditions such as its use as an adjunct to analgesia, and a potential
Dirty drug
Alimemazine Alimemazine (INN), also known as trimeprazine,; brand names Nedeltran, Panectyl, Repeltin, Therafene, Theraligene, Theralen, Theralene, Vallergan, Vanectyl, and Temaril), commonly provided as a tartrate salt, is a phenothiazine derivative that is used as an antipruritic (it prevents itching from causes such as eczema or poison ivy, by acting as an antihistamine). It also acts as a sedative, hypnotic, and antiemetic for prevention of motion sickness. Although it is structurally related to drugs such as chlorpromazine, it is not used as an antipsychotic. In the Russian Federation, it is marketed under the brand name Teraligen for the treatment of anxiety
Alimemazine
recorded the plate number of every vehicle in the lots. The Lenexa police, however, found no record that Randy had flown anywhere or left the country after checking with federal authorities. They therefore concentrated their search on the greater Kansas City metropolitan area. Joe Underhill, a private investigator hired by the family, looked through lakes and parks in both Kansas and Missouri where Potter might have gone to hunt, fish, or just walk. The Potters' daughter Nichole took fliers and passed them out on trips out of the area, as far away as Denver. On the morning of September 12,
Suicide of Randy Potter
the backs of ten thousand camels. Battle of Kapetron The Battle of Kapetron or Kapetrou () was fought between the Byzantine-Georgian armies and the Seljuq Turks on September 10 or September 18, 1048. It was the culmination of an Anatolian expedition of Ibrahim Inal and Qutalmish, a cousin of the sultan. The emperor Constantine IX requested help from the Georgian duke of Liparit IV of Kldekari, whom the Byzantines had aided in his struggle against the Georgian king Bagrat IV, to unite against the advancing Seljuqs; but ordered defensive strategy till the arrival of Georgian reinforcements. The battle was preceded
Battle of Kapetron
the level crossing and ramps. There is generally an hourly service Monday to Saturdays eastbound to Newcastle and westbound to Hexham with some services extending to Carlisle and additional calls at peak periods. Sundays there is generally an hourly service in each direction (westbound usually to Carlisle). Wylam railway station Wylam railway station is a railway station serving Wylam in Northumberland, England. It is located on the Newcastle and Carlisle Railway, west of Newcastle on the route to Carlisle. It was formerly one of two stations in Wylam, the other being North Wylam Station on the Scotswood, Newburn & Wylam
Wylam railway station
leading up to closure. The 1948 nationalisation of Britain's railways made the line part of the Southern Region of British Railways but inadequate funds were made available for railway modernisation to include railway backwaters such as the Cranleigh line. The weekday service of eight trains in each direction and an evening service to Cranleigh continued but the Sunday service was reduced to one train each way in the morning and evening. Commuters from Bramley and Cranleigh travelling up to London via Guildford were the main users of the line, and an additional service between Cranleigh and Guildford was offered to
Cranleigh line
2 July 1871 he ran for reelection as deputy for the Gironde but was defeated. Strongly affected by the disappearance of his two children in 1872, and then by the death of Louis Napoleon, he seemed tempted to abandon politics. However, on 6 October 1874 he was elected to the general council for the canton of Langon. He was reelected to Parliament for Bazas on 5 March 1876 after a campaign based on defending the achievements of the Empire and denouncing the Republic. He sat with the Appel au peuple group. He supported Albert de Broglie against the 363. David
Jérôme David
and estrogen), or a result of an infectious disease such as meningovascular syphilis, Lyme disease, viral encephalitis, and many others. Drug treatment is indicated for patients with severe disabling chorea. It is treated with haloperidol, chlorpromazine alone or in combination with diazepam, and also pimozide, which is another neuroleptic drug which may have fewer adverse effects than haloperidol. Valproic acid, chloral hydrate, risperidone, or phenobarbital can also be used. Chorea gravidarum Chorea gravidarum is a rare type of chorea which presents with involuntary abnormal movement, characterized by abrupt, brief, nonrhythmic, nonrepetitive movement of any limb, often associated with nonpatterned facial
Chorea gravidarum
similar to morphine. It can be given orally or intramuscularly. There is controversy regarding the use of opioids for people experiencing withdrawal symptoms since these agents can themselves cause relapse on patients when they suspend therapy. Clonidine is a non-opioid adjunct that can be used in situations where opioid use is not desired, such as in patients with high blood pressure. CNS depressants may enhance the depressant effects of hydromorphone, such as other opioids, anesthetics, sedatives, hypnotics, barbiturates, benzodiazepines, phenothiazines, chloral hydrate, dimenhydrinate, and glutethimide. The depressant effect of hydromorphone may also be enhanced by monoamine oxidase inhibitors (MAO inhibitors)
Hydromorphone
and/or less controlled motor movements, which may result in the tremors often experienced by those with Parkinson's. Increased levels of dopamine have long been implicated in the development of schizophrenia. However, much debate continues to this day surrounding this dopamine hypothesis of schizophrenia. Despite the controversy, dopamine antagonists remain a standard and successful treatment for schizophrenia. These antagonists include first generation (typical) antipsychotics such as butyrophenones, phenothiazines, and thioxanthenes. These drugs have largely been replaced by second-generation (atypical) antipsychotics such as clozapine and paliperidone. It should be noted that, in general, these drugs do not act on dopamine-producing neurons themselves,
Substantia nigra
Home care is available in the form of a peripherally-inserted central catheter (PICC) line for hydration and nutrition. Home treatment is often less expensive and reduces the risk for a hospital-acquired infection compared with long-term or repeated hospitalizations. A number of antiemetics are effective and safe in pregnancy including: pyridoxine/doxylamine, antihistamines (such as diphenhydramine), and phenothiazines (such as promethazine). With respect to effectiveness, it is unknown if one is superior to another for relieving nausea or vomiting. Limited evidence from published clinical trials suggests the use of medications to treat hyperemesis gravidarum. While pyridoxine/doxylamine, a combination of vitamin B and
Hyperemesis gravidarum
dopamine, a levodopa metabolite, activates), amphetamines and anticoagulants. It may also interact with anticholinergic drugs such as orphenadrine to produce hypoglycaemia (low blood sugar). Chlorpromazine may also interact with epinephrine (adrenaline) to produce a paradoxical fall in blood pressure. Monoamine oxidase inhibitors (MAOIs) and thiazide diuretics may also accentuate the orthostatic hypotension experienced by those receiving chlorpromazine treatment. Quinidine may interact with chlorpromazine to increase myocardialdepression. Likewise it may also antagonize the effects of clonidine and guanethidine. It also may reduce the seizure threshold and hence a corresponding titration of anticonvulsant treatments should be considered. Prochlorperazine and desferrioxamine may also
Chlorpromazine
antipsychotic
Title: Chlorpromazine. Content: health system. Its introduction has been labeled as one of the great advances in the history of psychiatry. It is available as a generic medication. The wholesale cost in the developing world is between US$0.02 and US$0.12 per day. In the United States it costs about US$2 per day. Chlorpromazine is classified as a low-potency typical antipsychotic and in the past was used in the treatment of both acute and chronic psychoses, including schizophrenia and the manic phase of bipolar disorder, as well as amphetamine-induced psychosis. Low-potency antipsychotics have more anticholinergic side effects, such as dry mouth, sedation, and constipation,
antipsychotics
antipsychotics
antipsychotic drugs
antipsychotic drugs
antipsychotic drugs
antipsychotic drugs