It is often said that [drugs for mental illness have great side effects! ] But if you ask carefully: What about the side effects of what? Most people are vague about this.
This article will introduce that all the drugs for mental illness have some side effects of what, and whether the side effects are big or not.
Is the disease what? Is the medicine what medicine?
Generally speaking, [psychosis] refers to a large category of mental disorders with psychotic symptoms as the main manifestations, of which the most important and famous is schizophrenia, and the others also include delusional disorders, schizophrenic mental disorders, schizophrenic affective disorders, etc.
The main drug for treating these diseases is antipsychotic drugs.
Antipsychotic drugs can be roughly divided into two categories according to different pharmacological effects:
The first type is called [typical antipsychotic drugs], represented by chlorpromazine, also called the first generation of antipsychotic drugs;
The second category is called [atypical antipsychotic drugs], and the common ones are clozapine and olanzapine, also called the second generation antipsychotic drugs.
Since the first and second generation drugs have great differences in pharmacological mechanism, clinical effects and side effects, they will be divided into two articles. This article mainly describes the side effects of typical antipsychotic drugs.
[Typical Antipsychotic] How Antipsychotic?
The first antipsychotic drug chlorpromazine was in the 1950s, If it is found to have the effect of improving psychotic symptoms such as hallucinations and delusions of schizophrenic patients, Subsequently, a series of drugs were also developed. The common mechanism of action of these drugs is to block a [dopamine receptor] in the brain-figuratively speaking, the [switch] of cells in the brain that make patients show abnormalities is cut off. These drugs are called [typical antipsychotic drugs].
Generally speaking, dopamine in the human brain has four pathways, corresponding to four functions respectively:
One is to adjust the movement of human body;
The second is to regulate the endocrine of hypothalamus.
The third is to regulate people’s cognitive function and emotional function.
The fourth is psychotic symptoms such as hallucinations and delusions related to schizophrenia.
In schizophrenic patients, the function of dopamine pathway, which regulates the last function, is greatly enhanced, thus causing symptoms such as hallucinations, delusions, attacks and hostility, while the function of dopamine pathway, which regulates cognition and emotion, decreases, while the other two pathways are normal.
As typical antipsychotic drugs cut off all [switches] [regardless of good or bad], the result is that mental symptoms such as hallucinations and delusions disappear and have therapeutic effects. However, other functions that are already low or normal are made even lower and no longer normal, which is the side effect of drugs.
What are the specific side effects?
Therefore, the common side effects of typical antipsychotic drugs include:
1. Side effects of motor system
This kind of side effect is because the dopamine system, which originally normally regulates motor function, has decreased its function due to the action of drugs, thus causing motor abnormalities.
Specific manifestations include:
- Stiffness of muscles; Trembling limbs; Move slowly; Lips and other parts involuntarily move slowly, doing movements similar to smacking the lips; Sometimes, the limbs suddenly stretch backward and outward spastically within a short period of time after medication. Because the muscles of the face are stiff, there may also be no facial expression, just like wearing a mask.
2. Elevated prolactin level
This is because the normal regulation of endocrine function is affected, resulting in an increase in prolactin.
In women, the increase of prolactin will cause amenorrhea and lactation. However, in men, the symptoms caused by the increase of prolactin at the general level are less obvious. If the increase level is high, it can cause male breast development and even milk secretion.
Because of this, the use of drugs that cause prolactin increase is more restricted in women than in men.
3. [Negative Symptoms] Aggravated
Before, in an article, I specifically introduced [negative symptoms] (click to read).
The original cognitive and emotional dopamine pathway function of schizophrenic patients has been reduced, and typical drugs can further worsen this situation.
The main symptoms are as follows:
- There is no pleasure experience for many things. Emotional experience disappeared, appearing to be particularly cold to people and impersonal. The willpower is morbidly reduced, even the willpower to wash one’s face and brush one’s teeth is gone, and one has no plans and plans for one’s future. Memory and problem-solving ability have deteriorated, so it is difficult to maintain the original complicated study and work.
4. Malignant Syndrome
Malignant syndrome is a rare but very serious antipsychotic adverse reaction, with specific manifestations including:
- Muscular tension; High fever; Even coma, death.
In theory, all drugs that can block dopamine receptors are likely to have such side effects. In addition, the consequences are serious, so even if the possibility of occurrence is small, doctors are very alert to this situation.
5. Other side effects
Because drugs not only act on D2 receptor, but also act on other receptors.
- Drugs acting on [histamine receptors] will cause drowsiness and lethargy. The drug acts on [acetylcholine M receptor], which will cause blurred vision, drooling, constipation, etc.
In addition, the side effects of such drugs include dizziness, postural hypotension, heart side effects, weight gain, etc.
At the same time, because the metabolic process of drugs in the body requires the participation of liver and kidney, different drugs have different burdens on liver and kidney functions.
The side effects of drugs are so great, what should we do?
Look, there are many side effects of typical antipsychotic drugs. To avoid these side effects, can family members and patients do some what?
First of all, of course, don’t choose drugs by yourself.
Some people listened to the people around them saying that they had taken what medicine and went to find the same medicine to take.
Different drugs have different side effects in different aspects. When selecting drugs for a specific patient, doctors will comprehensively consider the patient’s symptom characteristics, demographic characteristics such as sex and age, economic bearing capacity and other factors to select drugs that have less side effects on the person and are easier to insist on taking.
Can you choose it yourself better than the doctor?
Secondly, it is necessary to take the medicine according to the interval and dosage ordered by the doctor.
Some people feel that if they don’t eat well, they simply don’t eat or increase the amount without authorization, which is not safe.
Some of the side effects we mentioned earlier are dose-related-in other words, if the dose is high, the possibility of such side effects is greater, but it is not necessarily that the curative effect will double if the dose of drugs is doubled. If you use drugs indiscriminately, you should be careful not to eat what with liver damage and kidney damage.
It is even more undesirable to stop taking drugs without authorization, not to mention delaying treatment. What is more troublesome is that the body may suffer from severe maladjustment due to sudden withdrawal of drugs. Psychotropic drugs must be gradually added when starting to take them under the supervision of doctors, and gradually reduced when stopping drugs.
The last one is to identify a doctor and often go back to the clinic.
Schizophrenia is a chronic disease that requires long-term control. Some people never go again after prescribing medicine once, and some doctors forget to explain it to the patient’s family because they think it is common sense.
The reality is that taking medicine for a week or two cannot play a therapeutic role.
Moreover, family members (and patients) should understand the above side effects, learn to observe, and regularly do blood tests issued by doctors. If abnormalities are found, they must take patients to the doctor for face-to-face diagnosis and treatment to see if some treatment is needed for side effects.
Some patients’ families are not convenient to go to the hospital often, so they can try to ask the psychiatrist inside through [asking the doctor]. If the doctor determines that it is necessary to go to the hospital again, they can also save some expenses.
This time we are introducing older drugs, and the side effects are indeed more severe. Will the second generation of antipsychotic drugs be better? And will be decomposed next time.