Psychotropic drugs, especially antipsychotic drugs, have more side effects, the more specific ones are extrapyramidal reactions (EPS), including acute dystonia, tremor-like paralysis, inability to sit still, tardive dyskinesia (TD), hare lip syndrome; anticholinergic effects, dry mouth, constipation, blurred vision, difficulty urinating, urinary retention, tachycardia, etc.; effects on the endocrine system, occasionally breast enlargement The effects on the endocrine system may include breast enlargement, lactation, and menstrual changes. Commonly used drugs include benzhexol, promethazine, benadryl, bromocriptine, Shihuang Qinghe Oral Liquid, etc.
Name
Specification and packaging
Properties, usage and side effects
1
Benzhexol Ttihexyphenidyl, alias Artane 安坦
2mg*100
Anticholinergic drug, direct inhibition of the parasympathetic nervous system and release of muscle spasm effect. Used for the treatment of various Parkinson’s disease, can improve the symptoms of rigidity, dyskinesia, tremor, etc. Commonly used in the treatment of various pharmacogenic EPS. T1/2=1.7h, T1/2=3.7h after continuous dosing. oral start 1~2mg/dose, gradually can be increased to 4~12mg/d in divided doses, the extreme dose is 16mg/d.
Adverse reactions are lighter than atropine, such as dry mouth, dilated pupils, blurred vision, etc. Higher doses can cause tachycardia, agitation, delirium, hallucinations, etc. Glaucoma, urinary retention, myasthenia gravis, and delayed dyskinesia (TD) are contraindicated.
2
Scopolamine, alias Hyosine
0.3mg/ml
Peripheral and central anticholinergic effect, relieves salivation, tremor and muscle tonicity. It is mainly used in psychiatry for pharmacogenic EPS, especially acute dystonia, and also has significant central sedative and excitatory respiratory effects. It is commonly used in combination with haloperidol in rapid treatment. Intramuscular injection 0.15-0.3mg/dose.
Adverse effects are milder than atropine. There are dry mouth, photophobia, blurred vision, dizziness, drowsiness, etc. Excessive doses can cause delirium, agitation, and even convulsions. It is contraindicated in patients with glaucoma. Toxicity can be relieved by barbiturates or chloral hydrate, and neostigmine counteracts its peripheral effects.
3
Amantadine
100mg/tablet
Antiviral and antiparkinsonian agent that may act at the end of striatal DAergic neurons to promote DA release. Tmax is 2-4h, T1/2 about 15h. 90% of the drug is excreted in its original form through the kidneys, and a small amount is excreted in breast milk. Take 100mg orally, once in the morning and once in the evening, for up to 10 days.
Adverse reactions commonly include headache, dizziness, agitation, tremor, slurred speech, ataxia, muddy water and taste, anorexia, rash, etc. Overdose may cause convulsions.
4
Promethazine Promethazine, alias Phenergan Fenagan
12.5mg*100
25mg*100
25mg/ml
50mg/2ml
Phenothiazine, H1 receptor blocker, has sedative, hypothermic and antiemetic effects, and can strengthen the central inhibitory effects of hypnotics, analgesics and anesthetics. Used for various allergies, auxiliary anesthesia, artificial hibernation. Treatment of motility disorders, pregnancy vomiting and vomiting caused by various other reasons. Treatment of antipsychotic-induced dyskinesia, especially the efficacy of the treatment of TD is positive. tmax=1h, action 4-6h, T1/2=12.2h, mainly metabolized by the liver and excreted by the kidneys. Oral or intramuscular injection, sedation 25-50mg/dose, antiemetic or antihistamine 12.5-25mg.
Side effects are upright hypotension, drowsiness, sleepiness, dry mouth, occasional gastrointestinal irritation, dermatitis. Avoid driving vehicles, operating machines or working at height during the drug administration. It is not suitable to be mixed with aminophylline for injection, and it is contraindicated to be combined with alkaline and alkaloid drugs.
5
Cyclopentethione Anetholtrithione, trade name Sialor
25mg*60
Selective action in salivary deficiency associated with psychotropic drugs and hyposalivation due to radiotherapy. It has cholestatic effect and has no toxic effect on liver cells and biliary system. Brownish yellow powder, not easily soluble in water and alcohol. Take 1 tablet before each meal, 3 times a day. Those who take the drug to cause saliva reduction should stop taking the drug for 5 days a month when taking it continuously. The effect usually appears after a few days of taking the drug.
The yellow color of urine may appear after taking the drug, which is a normal phenomenon. Contraindications are biliary tract or common bile duct occlusion.
6
Bromocriptine
2.5mg/5mg
A semi-synthetic ergometrine derivative with direct agonistic effects on striatal DA receptors. In addition to the treatment of pharmacogenic EPS, it is also effective in some menopausal depression. It is also used for amenorrhea, overflowing breast, female infertility, PMS, pituitary tumors, etc. Oral absorption is incomplete, Tmax is 1.5-3h, T1/2 is 6-8h, duration of action is 3-5h, at doses >50mg, it can be maintained for 6-10h. Metabolized by the liver and partially excreted from the feces by bile secretion. Take 2.5mg orally, twice daily. Increase or decrease the dose as needed. Start with 12.5mg in the elderly.
The incidence of adverse reactions is high and gastrointestinal symptoms are evident and must be taken with food. Nausea, headache, dizziness, fatigue, abdominal cramps, constipation and diarrhea are common. High doses may cause mental disorders. Use with caution in patients with cardiac and hepatic insufficiency. Contraindicated in ischemic heart disease and pregnant women. Combination with phenothiazines or H2-blockers may significantly increase the serum concentration of prolactin and reduce the efficacy.
7
Propranolol, alias Inderal
10mg*100
Beta-blocker, used for the treatment of anxiety, phobia, mania, depression, memory disorders, etc. Anti-side effects are commonly used in the treatment of sinus tachycardia. Oral T1/2 is 22-33h. commonly used 10-20mg/dose, 2-3 times/d. Gradually reduce the drug after the heart rate drops to normal, do not withdraw the drug suddenly.
Not to be used in patients with asthma.
8
Neostigmine
0.5g/ml
1.0g/2ml
Cholinomimetic drug with anticholinesterase effect, but weak effect on central nervous system, strong effect on skeletal muscle and weak effect on pupil reduction. Mostly used for severe muscle weakness, intestinal paralysis after abdominal surgery, urinary retention, etc. Generally, for urinary retention, its methyl sulfate is injected intramuscularly at 0.5-1.0g/d, 1 to 2 times/d.
Large doses can cause nausea, vomiting, diarrhea, and increased secretion, which can be counteracted by atropine. It is contraindicated in patients with epilepsy, angina pectoris, ventricular tachycardia, mechanical intestinal obstruction and asthma.
8
Mestinone-Ambenonium
5mg*60
Acts slightly similar to neostigmine. Generally for urinary retention, take orally, 5 to 25mg/dose, 3 times/d.
9
Pyridostigmine
60mg*60
Acts slightly similar to neostigmine. Generally for urinary retention, take orally, 60-240mg/d in 3 divided doses.
10
Pyridostigmine Bromide
60mg*60
Slightly similar to neostigmine. Generally for urinary retention, take 60-240mg/d orally in 3 divided doses.
11
Shihuang Qinghe Oral Liquid (Beijing An Ding Hospital Preparation)
10ml*10
Pure Chinese medicine for the treatment of side effects preparation. It is composed of raw gypsum, liquor-derived rhubarb, raw groundnut, panax notoginseng and fried wheat sprouts. It nourishes Yin and clears heat, and opens up Yang-ming. It is mainly used to treat common side effects caused by antipsychotic drugs, such as: dizziness, weakness, lethargy, dull expression, straightening of the eyes, straightening of the neck, tremor of the limbs, muscle stiffness, inflexible movements, anxiety, restlessness, sitting and lying down, dry mouth, bad breath and salivation, short tongue and astringency. It is often used in combination with western drugs when the effect of side effects is not satisfactory. It has mild sedative effect. 1~2 sticks/time, 2~3 times/d.
Forbidden to be used in case of spleen deficiency and dampness. Overdose or inappropriate use may result in symptoms such as loose stools and may be reduced as appropriate.