eCollection 2020.Pietrini F, Albert U, Ballerini A, Calò P, Maina G, Pinna F, Vaggi M, Boggian I, Fontana M, Moro C, Carpiniello B.Neuropsychiatr Dis Treat. Haloperidol also lowers BDNF levels, reducing neuroprotection in the brain to enable haloperidol's toxic effects. Please enable it to take advantage of the complete set of features!
They increase levels of BDNF, improve cell survival and enhance neurogenesis.
The kind of several drugs that were developed in the 1990’s and now used to treat patients that have mental disorders.
2005 Apr;30(4):765-74. doi: 10.1038/sj.npp.1300603.Curr Opin Psychiatry. Clipboard, Search History, and several other advanced features are temporarily unavailable. Schizophrenia has been found to be a disease of progressive reductions in grey matter, and the more lost, the worse the outcome. Typical antipsychotics like dopamine … It is one of the most devastating diseases that exist, in terms of personal and social cost.It is estimated that some 20 million people in the world suffer from schizophrenia, there being no differences in the percentages of incidence of the different countries.Most of these people who have received a diagnosis of schizophrenia have to use antipsychotics to make their lives more stable and have fewer periods of hospitalization.Within the symptomatology of schizophrenia, it is important to differentiate positive and negative symptoms:Currently we can find two major types of antipsychotics: the classic neuroleptics and the atypical neuroleptics.They are antagonists of dopaminergic receptors, and their main pharmacological property is the blockade of D2 receptors, specifically in the mesolimbic pathway.The most common types of classic neuroleptics we can find are:In some cases, it increases the likelihood of suffering from physical illnesses such as diabetes or heart disease. Therefore, it is recommended to find the appropriate dose to help control the symptoms of schizophrenia with the least possible side effects.There are also classic neuroleptics with “retard” or depot action, which allow for more spaced doses over time:In the first two cases, a dose is administered every 3 weeks and, in the latter case, every 2 weeks.These classic neuroleptics are especially indicated for the treatment of:Movement disorders -tics- or Gilles de la Tourette syndrome.Among its adverse effects, we can find the following:Extrapyramidal effects: dystonias, parkinsonian effects, akathisia, etc.These drugs are based on the dopaminergic hypothesis, according to which positive psychotic symptoms are related to the hyperactivity of dopaminergic neurons, especially the mesolimbic pathway.Therefore, antipsychotic drugs used to treat positive symptoms act by blocking dopamine receptors, particularly dopamine D2 receptors.The negative symptoms of schizophrenia, described above, may involve other regions of the brain, such as the dorsolateral prefrontal cortex and other neurotransmitters – it may be related to the excitatory hyperactivity of glutamate.On the other hand, we find the group of atypical neuroleptics, which are those developed more recently.They constitute a heterogeneous group of substances that act on the positive and negative symptoms of schizophrenia – unlike classic neuroleptics , which only act on the positive ones.Some of the best known atypical antipsychotics are the following:Currently there is also an atypical neuroleptic that is being introduced, Ziprasidone.The data obtained so far show that it can be as effective as haloperidol for schizophrenia, although it has the disadvantage of causing nausea and vomiting.The injectable form has the added drawback of causing more pain at the injection site than haloperidol.It is still necessary to carry out more studies comparing this drug with the other atypical neuroleptics in order to draw conclusions about its real efficacy .Although these neuropsychotics cause less extrapyramidal effects than the classic ones, and they improve the negative symptoms of schizophrenia, they also have some side effects:Leucopenia – which sometimes ends in agranulocytosis, especially because of Clozapine.The serotonin-dopaminergic antagonists act as antagonists of dopamine -in D2 receptors-, but also act on serotonin -especially in 5HT2a receptors-.In schizophrenia, conventional or classic antipsychotics remain today the drugs of first choice in schizophrenia.Despite its side effects and limitations, it has been shown to be very effective in acute treatment and maintenance, being well tolerated by many patients.An additional advantage of these antipsychotics is the availability of some of them in parenteral dosage forms, of short duration or “depot” preparations .However, in those cases in which classical antipsychotics are not well tolerated due to their extrapyramidal effects, atypical antipsychotics are an adequate alternative.The reasons why they are not considered first-line drugs in schizophrenia are:Little knowledge about its safety and efficacy in maintenance therapy.Although some authors justify the use of the new antipsychotics in the “first” acute episode of schizophrenia and during the disease, based on the hypothesis of a decrease in relapse rates and associated morbidity and an improvement in the long-term results, there are no adequate clinical trials that assess these facts.There are also hypotheses about the advantages of atypical antipsychotics in reducing costs (shorter hospital stays, fewer rehospitalizations, etc.).
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