Anti dizzy med. Best Medicine for Vertigo: Comprehensive Guide to Meclizine HCL
What is the best anti-dizzy medication for vertigo. How does Meclizine HCL work to alleviate vertigo symptoms. What are the potential side effects and precautions of using Meclizine. How should Meclizine be taken for optimal effectiveness against vertigo.
Understanding Vertigo and Its Treatment Options
Vertigo, a sensation of spinning or dizziness, can be a debilitating condition affecting daily life. While various treatment options exist, Meclizine HCL has emerged as a popular and effective medication for managing vertigo symptoms. This comprehensive guide delves into the uses, efficacy, and considerations of Meclizine as an anti-dizzy medication.
Meclizine HCL: A Powerful Weapon Against Vertigo
Meclizine HCL, an antihistamine, is widely prescribed for vertigo and motion sickness. Its effectiveness lies in its ability to suppress the vestibular system, responsible for balance and spatial orientation. By dampening excessive stimulation in this system, Meclizine helps alleviate the spinning sensation associated with vertigo.
How does Meclizine work?
Meclizine acts on the central nervous system, specifically targeting histamine receptors. This action reduces the sensitivity of the inner ear to motion and position changes, thereby minimizing vertigo symptoms. Additionally, it has anticholinergic properties that further contribute to its anti-vertigo effects.
Proper Usage and Dosage Guidelines
To maximize the benefits of Meclizine while minimizing potential side effects, it’s crucial to follow proper usage guidelines:
- Follow prescribed dosage or package instructions diligently
- Take with or without food, as tolerated
- Chew chewable tablets thoroughly before swallowing
- For motion sickness prevention, take the first dose one hour before travel or activity
The dosage may vary based on individual medical conditions and response to treatment. It’s essential to consult with a healthcare provider for personalized recommendations.
Can Meclizine be used for long-term vertigo management?
While Meclizine is effective for short-term relief, long-term use should be discussed with a healthcare provider. Some patients may require ongoing treatment, while others may benefit from alternative therapies or lifestyle modifications in conjunction with medication.
Potential Side Effects and Precautions
As with any medication, Meclizine can cause side effects. Common side effects include:
- Drowsiness
- Dry mouth
- Fatigue
More serious side effects, though rare, may include:
- Mental/mood changes
- Fast/irregular heartbeat
- Tremors
- Difficulty urinating
It’s crucial to seek medical attention if any severe side effects occur. Additionally, patients should be aware of potential drug interactions and inform their healthcare provider of all medications and supplements they are taking.
Are there any contraindications for Meclizine use?
Meclizine may not be suitable for everyone. Contraindications include:
- Allergies to Meclizine or its ingredients
- Certain medical conditions (e.g., glaucoma, prostatic hypertrophy)
- Pregnancy (unless clearly necessary and discussed with a doctor)
- Breastfeeding (consult with a healthcare provider)
Meclizine vs. Other Vertigo Treatments
While Meclizine is a popular choice, other medications and treatments for vertigo exist. Comparing their efficacy and suitability can help patients and healthcare providers make informed decisions:
Pharmaceutical alternatives
- Dimenhydrinate: Another antihistamine with similar effects to Meclizine
- Promethazine: Effective for severe nausea associated with vertigo
- Betahistine: Commonly used in Europe, not FDA-approved in the US
Non-pharmaceutical approaches
- Vestibular rehabilitation therapy: Exercises to improve balance and reduce dizziness
- Canalith repositioning procedures: Specific maneuvers for BPPV (Benign Paroxysmal Positional Vertigo)
- Lifestyle modifications: Dietary changes, stress reduction, and sleep improvements
The choice of treatment often depends on the underlying cause of vertigo and individual patient factors. A comprehensive evaluation by a healthcare professional can determine the most appropriate approach.
Maximizing Meclizine’s Effectiveness
To get the most out of Meclizine treatment, consider the following tips:
- Take as directed: Consistency in timing and dosage is key
- Avoid alcohol: It can intensify drowsiness and dizziness
- Be cautious with activities: Until you know how Meclizine affects you, avoid driving or operating machinery
- Stay hydrated: Combat dry mouth, a common side effect
- Monitor and report: Keep track of symptoms and side effects, reporting any concerns to your healthcare provider
Can lifestyle changes enhance Meclizine’s efficacy?
Indeed, certain lifestyle modifications can complement Meclizine treatment:
- Balanced diet: Reducing salt and caffeine intake may help some patients
- Regular exercise: Improves overall balance and reduces vertigo episodes
- Stress management: Techniques like meditation can minimize vertigo triggers
- Adequate sleep: Proper rest supports the vestibular system’s function
Long-term Considerations and Follow-up Care
While Meclizine can provide significant relief from vertigo symptoms, it’s essential to view it as part of a comprehensive treatment plan. Regular follow-ups with healthcare providers ensure optimal management and allow for adjustments as needed.
When should patients consider alternative treatments?
Patients should discuss alternative options with their healthcare provider if:
- Meclizine doesn’t provide adequate relief after a reasonable trial period
- Side effects become problematic or intolerable
- The underlying cause of vertigo requires a different approach
- Long-term use raises concerns about dependency or efficacy
Remember, vertigo management is often a dynamic process that may require adjustments over time. Open communication with healthcare providers is crucial for optimal outcomes.
Patient Experiences and Success Stories
Many patients have found significant relief from vertigo symptoms through Meclizine treatment. Here are some common themes from patient experiences:
- Rapid onset of action, often providing relief within an hour
- Improved ability to perform daily activities and work tasks
- Enhanced quality of life due to reduced vertigo episodes
- Successful management of motion sickness during travel
However, it’s important to note that individual responses can vary. Some patients may need to try different dosages or combinations of treatments to find the optimal solution for their specific case.
How do patient experiences inform treatment decisions?
While anecdotal evidence shouldn’t replace medical advice, patient experiences can:
- Provide insights into real-world effectiveness and side effects
- Help set realistic expectations for treatment outcomes
- Encourage open dialogue between patients and healthcare providers
- Inspire hope and adherence to treatment plans
Healthcare providers often consider patient feedback alongside clinical data to tailor treatment approaches effectively.
Future Developments in Vertigo Treatment
As medical research advances, new treatments and improvements to existing therapies for vertigo are on the horizon. Some promising areas of development include:
- Targeted drug delivery systems to minimize systemic side effects
- Gene therapy approaches for inherited vestibular disorders
- Advanced vestibular implants for severe cases of balance dysfunction
- AI-powered diagnostic tools for more accurate and rapid vertigo diagnosis
- Personalized medicine approaches based on genetic and biomarker profiles
While Meclizine remains a cornerstone of vertigo treatment, ongoing research may lead to even more effective and tailored solutions in the future.
How might future treatments complement or replace Meclizine?
Emerging therapies could potentially:
- Offer longer-lasting relief with fewer side effects
- Provide more targeted treatment for specific types of vertigo
- Combine medication with advanced rehabilitative technologies
- Address underlying causes more effectively, reducing reliance on symptomatic treatment
As these developments unfold, patients and healthcare providers will have an expanding toolkit for managing vertigo, potentially improving outcomes and quality of life for those affected by this challenging condition.
Navigating Insurance Coverage and Accessibility
While Meclizine is generally affordable, especially in its over-the-counter forms, insurance coverage and accessibility can vary. Consider the following factors:
- Prescription vs. OTC: Some insurance plans may cover prescription Meclizine but not OTC versions
- Generic options: These are often more cost-effective and widely covered
- Dosage and form: Coverage may differ for various strengths and formulations
- Prior authorization: Some plans may require doctor approval for coverage
Patients should check with their insurance providers and explore pharmacy discount programs to optimize affordability.
How can patients ensure consistent access to Meclizine?
To maintain a steady supply of medication:
- Use mail-order pharmacy services for regular refills
- Keep a backup supply for emergencies or travel
- Discuss long-term treatment plans with healthcare providers to anticipate needs
- Consider patient assistance programs if facing financial hardships
Proactive planning can help prevent treatment interruptions and ensure continuous management of vertigo symptoms.
Meclizine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing
Uses
How to use Meclizine HCL
Follow all directions on the product package. If your doctor has prescribed this medication, take it as directed. If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth with or without food. If you are taking the chewable tablets, chew the tablet thoroughly before swallowing.
The dosage is based on your medical condition and response to treatment. Do not increase your dose or take this medication more often than directed.
To prevent motion sickness, take the first dose one hour before starting activity such as travel.
Tell your doctor if your condition does not improve or if it worsens.
Side Effects
Drowsiness, dry mouth, and tiredness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.
To relieve dry mouth, suck (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.
If your doctor has directed you to use this medication, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor right away if you have any serious side effects, including: mental/mood changes (such as restlessness, confusion), fast/irregular heartbeat, shaking (tremor), difficulty urinating.
Get medical help right away if you have any very serious side effects, including: seizures.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.
In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Precautions
Before taking meclizine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: breathing problems (such as asthma, emphysema), high pressure in the eye (glaucoma), heart problems, high blood pressure, seizures, stomach/intestine problems (such as ulcers, blockage), overactive thyroid (hyperthyroidism), difficulty urinating (for example, due to enlarged prostate), liver problems, kidney problems.
This drug may make you drowsy. Alcohol or marijuana (cannabis) can make you more drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
Children may be more sensitive to the side effects of this drug. This drug can often cause excitement in young children instead of drowsiness.
Older adults may be more sensitive to the side effects of this drug, especially drowsiness, confusion, or trouble urinating. Drowsiness and confusion can increase the risk of falling.
During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.
It is unknown if this drug passes into breast milk. Consult your doctor before breastfeeding.
Interactions
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
Some products that may interact with this drug include: antihistamines applied to the skin (such as diphenhydramine cream, ointment, spray).
Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or other antihistamines (such as cetirizine, diphenhydramine).
Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.
This medication may interfere with certain lab tests (such as allergy skin test), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.
Does Meclizine HCL interact with other drugs you are taking?
Enter your medication into the WebMD interaction checker
Overdose
If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe drowsiness, seizures, widened pupils. In children, mental/mood changes (such as restlessness, irritability, hallucinations) may occur before drowsiness.
Keep all medical and lab appointments.
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Images
meclizine 25 mg tablet
Color: whiteShape: ovalImprint: logo and 14
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 25 mg chewable tablet
Color: pinkShape: roundImprint: 21 G
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 25 mg tablet
Color: light yellowShape: ovalImprint: AN 442
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 12.5 mg tablet
Color: white,blueShape: ovalImprint: L 34
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 25 mg chewable tablet
Color: light pinkShape: roundImprint: 5172
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 25 mg tablet
Color: yellow,whiteShape: ovalImprint: 49 L
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 25 mg tablet
Color: yellowShape: ovalImprint: TL 121
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 12.5 mg tablet
Color: blueShape: ovalImprint: TL 122
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 25 mg tablet
Color: whiteShape: ovalImprint: M C
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 25 mg tablet
Color: pinkShape: roundImprint: I60
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 12.5 mg tablet
Color: light blueShape: ovalImprint: AN 441
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 25 mg chewable tablet
Color: pinkShape: roundImprint: logo and 115
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 12.5 mg tablet
Color: whiteShape: oblongImprint: logo and 117
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 25 mg chewable tablet
Color: pinkShape: roundImprint: 21 G
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 12.5 mg tablet
Color: whiteShape: roundImprint: M MCZ 12
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 25 mg tablet
Color: light yellowShape: ovalImprint: 1162
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 12.5 mg tablet
Color: whiteShape: roundImprint: A C4
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 25 mg tablet
Color: whiteShape: roundImprint: AM7
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 25 mg tablet
Color: yellowShape: roundImprint: AM4
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 12.5 mg tablet
Color: pinkShape: roundImprint: I50
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 12.5 mg tablet
Color: whiteShape: oblongImprint: 19 G
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 12.5 mg tablet
Color: whiteShape: oblongImprint: PH049
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 25 mg tablet
Color: whiteShape: roundImprint: M MCZ 25
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 25 mg tablet
Color: yellowShape: ovalImprint: par 035
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 12.5 mg tablet
Color: light blueShape: ovalImprint: 1161
This medicine is a white, oval, tablet imprinted with “logo and 14”.
meclizine 12.5 mg tablet
Color: blueShape: ovalImprint: logo and 12
This medicine is a white, oval, tablet imprinted with “logo and 14”.
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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.
Antivert: Uses, Dosage & Side Effects
Generic name: meclizine [ MEK-li-zeen ]
Drug class: Anticholinergic antiemetics
Medically reviewed by Philip Thornton, DipPharm. Last updated on Jun 14, 2023.
What is Antivert?
Antivert is an antihistamine that reduces the effects of natural chemical histamine in the body.
Antivert is used to treat or prevent nausea, vomiting, and dizziness caused by motion sickness.
Antivert is also used to treat symptoms of vertigo (dizziness or spinning sensation) caused by disease that affects your inner ear.
Warnings
Before you take Antivert, tell your doctor if you have liver or kidney disease, asthma, glaucoma, an enlarged prostate, or urination problems.
This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Drinking alcohol can increase certain side effects of meclizine.
Cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by meclizine.
Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.
Before taking this medicine
You should not use Antivert if you are allergic to meclizine.
Antivert should not be given to a child younger than 12 years old.
Do not give meclizine to a child without medical advice.
To make sure this medicine is safe for you, tell your doctor if you have ever had:
Tell your doctor if you are pregnant or breast-feeding.
How should I take Antivert?
Use Antivert exactly as directed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets.
To prevent motion sickness, take Antivert about 1 hour before you travel or anticipate having motion sickness. You may take Antivert once every 24 hours while you are traveling, to further prevent motion sickness.
To treat vertigo, you may need to take Antivert several times daily. Follow your doctor’s instructions.
This medicine can affect the results of allergy skin tests. Tell any doctor who treats you that you are using this medicine.
Store at room temperature away from moisture, heat, and light.
Dosing information
Usual Adult Dose for Vertigo:
-25 to 100 mg orally per day in divided doses
-Dosing dependent upon clinical response.
Use: Management of vertigo associated with diseases affecting the vestibular system.
Usual Adult Dose for Motion Sickness:
-Initial Dose: 25 to 50 mg orally 1 hour before travel
-Maintenance Dose: Repeat dose every 24 hours if needed
Use: Management of nausea, vomiting, and dizziness associated with motion sickness.
Usual Pediatric Dose for Vertigo:
Age 12 years and older:
-25 to 100 mg orally per day in divided doses
-Dosing dependent upon clinical response.
Use: Management of vertigo associated with diseases affecting the vestibular system.
Usual Pediatric Dose for Motion Sickness:
Age 12 years and older:
-Initial Dose: 25 to 50 mg orally 1 hour before travel
-Maintenance Dose: Repeat dose every 24 hours if needed
Use: Management of nausea, vomiting, and dizziness associated with motion sickness.
What happens if I miss a dose?
Since Antivert is sometimes taken only when needed, you may not be on a dosing schedule. Skip any missed dose if it’s almost time for your next dose. Do not use two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What to avoid
Avoid driving or hazardous activity until you know how meclizine will affect you. Your reactions could be impaired.
Drinking alcohol can increase certain side effects of meclizine.
Antivert side effects
Get emergency medical help if you have signs of an allergic reaction to Antivert: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Common Antivert side effects may include:
drowsiness;
dry mouth;
headache;
vomiting; or
feeling tired.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect Antivert?
Using Antivert with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.
Other drugs may interact with meclizine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.
More about Antivert (meclizine)
- Check interactions
- Compare alternatives
- Pricing & coupons
- Reviews (13)
- Drug images
- Side effects
- Dosage information
- During pregnancy
- Generic availability
- Drug class: anticholinergic antiemetics
- Breastfeeding
Patient resources
Other brands
Dramamine Less Drowsy, Dramamine II, Meclicot, Meni-D, Travel Sickness
Professional resources
- Prescribing Information
Related treatment guides
- Vertigo
- Motion Sickness
- Nausea/Vomiting
Further information
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Antivert only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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Medicines for mental illness
The effectiveness of drug therapy with psychotropic drugs is determined by the compliance of the choice of the drug with the clinical picture of the disease, the correctness of its dosing regimen, the method of administration and the duration of the therapeutic course. As in any field of medicine, in psychiatry it is necessary to take into account the entire complex of drugs that the patient takes, since their mutual action can lead not only to a change in the nature of the effects of each of them, but also to the occurrence of undesirable consequences.
There are several approaches to the classification of psychotropic drugs. Table 1 shows the classification proposed by the WHO in 1990, adapted to include some domestic medicines.
Table 1. Classification of psychopharmacological drugs.
Grade | Chemical group | Generic and common trade names |
Antipsychotics | Phenothiazines | Chlorpromazine (chlorpromazine), promazine, thioproperazine (majeptil), trifluperazine (stelazine, triftazine), periciazine (neuleptil), alimemazine (teralen) |
Xanthenes and thioxanthenes | Chlorprothixene, Clopenthixol (Clopexol), Flupentixol (Fluanxol) | |
Butyrophenones | Haloperidol, trifluperidol (trisedil, triperidol), droperidol | |
Piperidine derivatives | Fluspirilene (imap), pimozide (orap), penfluridol (semap) | |
Cyclic derivatives | Risperidone (rispolept), ritanserin, clozapine (leponex, azaleptin) | |
Indole and naphthol derivatives | Molindol (moban) | |
Benzamide derivatives | Sulpiride (eglonil), metoclopramide, racloprid, amisulpiride, sultopride, tiapride (tiapridal) | |
Derivatives of other substances | Olanzapine (Zyprexa) | |
Tranquilizers | Benzodiazepines | Diazepam (Valium, Seduxen, Relanium), Chlordiazepoxide (Librium, Elenium), Nitrazempam (Radedorm, Eunoctin) |
Triazolobenzodiazepines | Alprazolam (Xanax), Triazolam (Chalcion), Madizopam (Dormicum) | |
Heterocyclic | Brotizopam (lendormin) | |
Diphenylmethane derivatives | Benactizine (staurodorm), hydroxyzine (atarax) | |
Heterocyclic derivatives | Busperone (buspar), zopiclone (imovan), clometizol, gemineurin, zolpidem (ivadal) | |
Antidepressants | Tricyclic | Amitriptyline (Triptisol, Elivel), Imipramine (Melipramine), Clomipramine (Anafranil), Tianeptine (Coaxil) |
Tetracyclic | Mianserin (Lerivon), Maprotiline (Ludiomil), Pyrlindol (Pyrazidol), | |
Serotonergic | Citalopram (Seroprax), Sertraline (Zoloft), Paroxetine (Paxil), Viloxazine (Vivalan), Fluoxetine (Prozac), Fluvoxamine (Fevarin), | |
Noradrenergic and specific serotonergic antidepressants (NaSSA) | Mirtazapine (remeron), milnacipran (ixel) | |
MAO inhibitors (reversible) | Moclobemide (Aurorix) | |
Nootropics (as well as substances with a nootropic component of action) | Pyrrolidone derivatives | Piracetam (nootropil) |
Cyclic derivatives, GABA | Pantogam, Phenibut, Gammalon (Aminalone) | |
Acetylcholine precursors | Deanol (acti-5) | |
Pyridoxine derivatives | Pyritinol | |
Devincan derivatives | Vincamine, Vinpocetine (Cavinton) | |
Neuropeptides | Vasopressin, oxytocin, thyroliberin, cholecystokinin | |
Antioxidants | Ionol, mexidol, tocopherol | |
Stimulants | Phenethylamine derivatives | Amphetamine, salbutamol, methamphetamine (Pervitine) |
Sydnonimine derivatives | Sydnocarb | |
Heterocyclic | Methylphnidate (Ritalin) | |
Purine derivatives | Caffeine | |
Normotimics | Metal salts | Lithium salts (lithium carbonate, lithium hydroxybutyrate, lithonite, micalite), rubidium chloride, cesium chloride |
Assembly group | Carbamazepine (finlepsin, tegretol), valpromide (depamide), sodium valproate (depakin, convulex) | |
Additional group | Assembly group | Amino acids (glycine), opium receptor antagonists (naloxone, naltrexone), neuropeptides (bromocriptine, thyroliberin) |
The main clinical characteristics and side effects of the listed classes of pharmacological drugs are given below.
Antipsychotics
Clinical characteristics. This class of drugs is central to the treatment of psychoses. However, the scope of their application is not limited to this, since in small doses in combination with other psychotropic drugs they can be used in the treatment of affective disorders, anxiety-phobic, obsessive-compulsive and somatoform disorders, with decompensation of personality disorders.
Regardless of the characteristics of the chemical structure and mechanism of action, all drugs of this group have similar clinical properties: they have a pronounced antipsychotic effect, reduce psychomotor activity and reduce mental arousal, neurotropic action, manifested in the development of extrapyramidal and vegetovascular disorders, many of they also have antiemetic properties.
Side effects. The main side effects in the treatment of neuroleptics form the neuroleptic syndrome. The leading clinical manifestations of this syndrome are extrapyramidal disorders with a predominance of either hypo- or hyperkinetic disorders. Hypokinetic disorders include drug-induced parkinsonism, manifested by increased muscle tone, lockjaw, rigidity, stiffness, and slowness of movement and speech. Hyperkinetic disturbances include tremor and hyperkinesis. Usually in the clinical picture in various combinations there are both hypo- and hyperkinetic disorders. The phenomena of dyskinesia can be paroxysmal in nature, localized in the mouth area and manifested by spasmodic contractions of the muscles of the pharynx, tongue, lips, jaws. Often there are phenomena of akathisia – feelings of restlessness, “restlessness in the legs”, combined with tasikinesia (the need to move, change position). A special group of dyskinesias includes tardive dyskinesia, which occurs after 2-3 years of taking antipsychotics and is expressed in involuntary movements of the lips, tongue, face.
Among the disorders of the autonomic nervous system, orthostatic hypotension, sweating, weight gain, changes in appetite, constipation, diarrhea are most often observed. Sometimes there are anticholinergic effects – visual disturbances, dysuric phenomena. Possible functional disorders of the cardiovascular system with changes in the ECG in the form of an increase in the Q-T interval, a decrease in the T wave or its inversion, tachycardia or bradycardia. Sometimes there are side effects in the form of photosensitivity, dermatitis, skin pigmentation; skin allergic reactions are possible.
Antipsychotics of new generations, compared with traditional derivatives of phenothiazines and butyrophenones, cause significantly fewer side effects and complications.
Tranquilizers
Clinical characteristics. This group includes psychopharmacological agents that relieve anxiety, emotional tension, fear of non-psychotic origin, and facilitate the process of adaptation to stress factors. Many of them have anticonvulsant and muscle relaxant properties. Their use in therapeutic doses does not cause significant changes in cognitive activity and perception. Many of the drugs in this group have a pronounced hypnotic effect and are used primarily as hypnotics. Unlike neuroleptics, tranquilizers do not have a pronounced antipsychotic activity and are used as an additional tool in the treatment of psychosis – to stop psychomotor agitation and correct the side effects of neuroleptics.
Side effects of during treatment with tranquilizers are most often manifested by daytime drowsiness, lethargy, muscle weakness, impaired concentration, short-term memory, as well as a slowdown in the rate of mental reactions. In some cases, paradoxical reactions develop in the form of anxiety, insomnia, psychomotor agitation, hallucinations. Among the dysfunctions of the autonomic nervous system and other organs and systems, hypotension, constipation, nausea, urinary retention or incontinence, decreased libido are noted. Long-term use of tranquilizers is dangerous due to the possibility of developing addiction to them, i.e. physical and mental dependence.
Antidepressants
Clinical characteristics. This class of drugs includes drugs that increase the pathological hypothymic effect, as well as reduce somatovegetative disorders caused by depression. A growing body of scientific evidence now suggests that antidepressants are effective for phobic anxiety and obsessive-compulsive disorders. It is assumed that in these cases, not the actual antidepressant, but the anti-obsessional and antiphobic effects are realized. There is data confirming the ability of many antidepressants to increase the threshold of pain sensitivity, to have a preventive effect in migraine and vegetative crises.
Side effects. Side effects related to the central nervous system and the autonomic nervous system are expressed by dizziness, tremor, dysarthria, impaired consciousness in the form of delirium, epileptiform seizures. Possible exacerbation of anxious disorders, activation of suicidal tendencies, inversion of affect, drowsiness or, conversely, insomnia. Side effects may be manifested by hypotension, sinus tachycardia, arrhythmia, impaired atrioventricular conduction.
When taking tricyclic antidepressants, various anticholinergic effects are often observed, as well as an increase in appetite. With the simultaneous use of MAO inhibitors with food products containing tyramine or its precursor – tyrosine (cheeses, etc.), a “cheese effect” occurs, manifested by hypertension, hyperthermia, convulsions and sometimes leading to death.
When prescribing serotonin reuptake inhibitors (SSRIs) and reversible MAO-A inhibitors, there may be disturbances in the activity of the gastrointestinal tract, headaches, insomnia, anxiety, and impotence may develop against the background of SSRIs. In the case of a combination of SSRIs with drugs of the tricyclic group, the formation of the so-called serotonin syndrome, which is manifested by an increase in body temperature and signs of intoxication, is possible.
Normotimics
Clinical characteristics. Normotimics include drugs that regulate affective manifestations and have a preventive effect in phasic affective psychoses. Some of these drugs are anticonvulsants.
Side effects of when using lithium salts are most often tremor. Often there are violations of the function of the gastrointestinal tract – nausea, vomiting, loss of appetite, diarrhea. Often there is an increase in body weight, polydipsia, polyuria, hypothyroidism. Acne, maculo-papular rash, alopecia, as well as worsening of psoriasis are possible.
Signs of severe toxic conditions and overdose of the drug are a metallic taste in the mouth, thirst, severe tremor, dysarthria, ataxia; in these cases, the drug should be stopped immediately.
It should also be noted that side effects may be associated with non-compliance with the diet – a large intake of liquid, salt, smoked meats, cheeses.
Side effects of anticonvulsants are most often associated with functional disorders of the central nervous system and manifest as lethargy, drowsiness, ataxia. Hyperreflexia, myoclonus, tremor can be observed much less frequently. The severity of these phenomena is significantly reduced with a smooth increase in doses.
With a pronounced cardiotoxic effect, atrioventricular block may develop.
Nootropics
Clinical characteristics. Nootropics include drugs that can positively affect cognitive functions, stimulate learning, enhance memory processes, increase brain resistance to various adverse factors (in particular, to hypoxia) and extreme stress. However, they do not have a direct stimulating effect on mental activity, although in some cases they can cause anxiety and sleep disturbance.
Side effects – rare. Sometimes there are nervousness, irritability, elements of psychomotor agitation and disinhibition of drives, as well as anxiety and insomnia. Dizziness, headache, nausea and abdominal pain may occur.
Psychostimulants
Clinical characteristics.