Neuroleptic Drugs Research Articles

Antipsychotic polypharmacy among schizophrenia outpatients

IntroductionSince their introduction by Delay and Deniker in the 1950s, neuroleptic drugs have significantly modified the evolutionary prognosis of schizophrenia. Their combination has also become a widespread practice.ObjectivesThe aim of this study was to analyze the associations of neuroleptic drugs by describing the characteristics of types and doses, understanding the reasons for these associations and studying the relationship existing in such situation regarding adherence to treatment, tolerance and the number of hospitalizations.MethodsOur study was retrospective, descriptive and analytical. It has been conducted from March, 1st to May, 30th 2015 and involved 70 stabilized patients diagnosed with schizophrenia according to DSM 5. Clinical characteristics were collected from patients and their medical records. Evaluations were conducted using PANSS, MARS and GAS.ResultsOverall, 70 male patients were recruited. The mean age was 40 years old: 30% received classical monotherapy while 70% were treated only by an atypical antipsychotic. Among patients receiving two drugs, 85% received classical bitherapy while 9% were under both classical and atypical drugs. Only 6% received atypical bitherapy. Chlorpromazine equivalent doses in case of monotherapy was 325.92 mg/day, while it reached 1148.65 mg/day in case of drugs association. Administration of a combined therapy had poor tolerance rate and all patients suffered from adverse effects. Adherence to treatment was better while receiving monotherapy (88% versus 45%) and the number of hospitalizations was lower with an average of 3 against 10.ConclusionOur study revealed several shortcomings in our current management of patients with schizophrenia and addressed the implication of socioeconomic status on therapeutic outcomes.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Systemic thioridazine in combination with dicloxacillin against early aortic graft infections caused by Staphylococcus aureus in a porcine model: In vivo results do not reproduce the in vitro synergistic activity

IntroductionConservative treatment solutions against aortic prosthetic vascular graft infection (APVGI) for inoperable patients are limited. The combination of antibiotics with antibacterial helper compounds, such as the neuroleptic drug thioridazine (TDZ), should be explored.AimTo investigate the efficacy of conservative systemic treatment with dicloxacillin (DCX) in combination with TDZ (DCX+TDZ), compared to DCX alone, against early APVGI caused by methicillin-sensitive Staphylococcus aureus (MSSA) in a porcine model.MethodsThe synergism of DCX+TDZ against MSSA was initially assessed in vitro by viability assay. Thereafter, thirty-two pigs had polyester grafts implanted in the infrarenal aorta, followed by inoculation with 106 CFU of MSSA, and were randomly administered oral systemic treatment with either 1) DCX or 2) DCX+TDZ. Treatment was initiated one week postoperatively and continued for a further 21 days. Weight, temperature, and blood samples were collected at predefined intervals. By termination, bacterial quantities from the graft surface, graft material, and perigraft tissue were obtained.ResultsDespite in vitro synergism, the porcine experiment revealed no statistical differences for bacteriological endpoints between the two treatment groups, and none of the treatments eradicated the APVGI. Accordingly, the mixed model analyses of weight, temperature, and blood samples revealed no statistical differences.ConclusionConservative systemic treatment with DCX+TDZ did not reproduce in vitro results against APVGI caused by MSSA in this porcine model. However, unexpected severe adverse effects related to the planned dose of TDZ required a considerable reduction to the administered dose of TDZ, which may have compromised the results.

Toxicity assessment of molindone hydrochloride, a dopamine D2/D5 receptor antagonist in juvenile and adult rats

Neuroleptic drug molindone hydrochloride is a dopamine D2/D5 receptor antagonist and it is in late stage development for the treatment of impulsive aggression in children and adolescents who have attention deficient/hyperactivity disorder (ADHD). This new indication for this drug would expand the target population to include younger patients, and therefore, toxicity assessments in juvenile animals were undertaken in order to determine susceptibility differences, if any, between this age group and the adult rats. Adult rats were administered molindone by oral gavage for 13 weeks at dose levels of 0, 5, 20, or 60 mg/kg-bw/day. Juvenile rats were dosed for 8 weeks by oral gavage at dose levels of 0, 5, 25, 50, or 75 mg/kg-bw/day. Standard toxicological assessments were made using relevant study designs in consultation with FDA. Treatment-related elevation in serum cholesterol and triglycerides and decreases in glucose levels were observed in both the age groups. Organ weight changes included increases in liver, adrenal gland and seminal vesicles/prostate weights. Decreases in uterine weights were also observed in adult females exposed to the top two doses with sufficient exposure. In juveniles, sexual maturity parameters secondary to decreased body weights were observed, but, were reversed. In conclusion, the adverse effects noted in reproductive tissues of adults were attributed to hyperprolactinemia and these changes were not considered to be relevant to humans due to species differences in hormonal regulation of reproduction. On the whole, there were no remarkable differences in the toxicity profile of the drug between the two age groups.

Understanding Polymorphic Control of Pharmaceuticals Using Imidazolium-Based Ionic Liquid Mixtures as Crystallization Directing Agents

Imidazolium-based room temperature ionic liquids (RTILs) were tested to assess their ability to control molecular polymorphic behavior. Mixtures of RTILs with distinct cation/anion combinations revealed promising capabilities in directing the crystallization process toward less stable polymorphs. In our tests, gabapentin (GBP) neuroleptic drug was used as a case study, as it is a well know polymorphic active pharmaceutical ingredient. For the first time, pure “bulk” GBP Form IV, a highly unstable polymorph, was isolated through RTILs. Forms were maintained over time, once they were kept soaked, opening new perspectives for the method presented here. Molecular dynamics (MD) simulations clearly supported the results. In this work the polymorphic behavior of GBP is controlled recurring to the use of different pure imidazolium-based RTILs or mixtures, as crystallization solvents. Molecular dynamics simulations clearly supported the results showing that specific H(acidic(C4/C6mim))···O(carboxylate) interaction...

The differential effects of neuroleptic drugs and PACAP on the expression of BDNF mRNA and protein in a human glioblastoma cell line

Despite numerous studies, the molecular mechanisms underpinning the action of antipsychotic drugs remain not fully understood. It has been suggested that, in addition to the modulation of monoaminergic neurotransmission, antipsychotic drugs can also affect the expression of neurotrophic factors in the brain. The present study examines the effects of a first-generation neuroleptic drug (FGA; haloperidol) and two second-generation neuroleptic drugs (SGAs; olanzapine and amisulpride) on the expression and levels of brain-derived neurotrophic factor (BDNF) in an astrocyte-like T98G glioblastoma cell line. The effects of these drugs were compared to the action of PACAP38, a neuropeptide with well-known BDNF-mediated neuroprotective effects. The tested neuroleptics differentially regulated the mRNA expression and protein level of BDNF depending on concentration and incubation time. Real-time PCR analysis demonstrates that, of the three tested neuroleptics, both haloperidol and olanzapine at a concentration of 5 µM (but not at 20 µM) increased BDNF mRNA expression with similar efficacy after 72-hour incubation. In order to confirm the observed changes in the mRNA expression of BDNF, a protein expression assay was performed. The exposure of cells to 5 μM olanzapine alone for 72 hours increased BDNF concentration in the culture medium by 29%. Additionally, PACAP significantly up-regulated BDNF mRNA expression in T98G cells and the obtained results correlated positively with the increased production of BDNF protein, 22% above control values. Our findings show that olanzapine, similarly to exogenous PACAP38, increased BDNF mRNA expression and protein release, which can contribute to its neuroprotective mechanism of action in the cells of non-neuronal origin. The results of the paper show that olanzapine, similarly to exogenous PACAP38, increased BDNF mRNA expression and protein release, which can contribute to its neuroprotective mechanism of action in the cells of nonneuronal origin. The results of the present paper confirm the findings that BDNF may represent the key target for olanzapine and PACAP.

Anticholinergic Use and Misuse in Psychiatry: A Comprehensive and Critical Review

Anticholinergic medications such as Trihexyphenidyl; Biperidine are widely prescribed to prevent or to treat extrapyramidal side effects produced by neuroleptic drugs. Concomitant use of anticholinergic drugs is more common with the first generation antipsychotic medications. There is a considerable body of data suggesting that anticholinergic drugs have a potential of abuse. In this article, we review the psychiatric use, mechanism of action and the abuse of each anticholinergic drug.

The Impact of Drug and Gene Interaction on the Antipsychotic Medication for Schizophrenia

Objective: Schizophrenia, a neuropsychiatric disorder, is known to be neurodevelopmentally progressive. Due to the extensive interindividual variability found in the responses of patients, management of schizophrenia has proven to be challenging. This interindividual variability to treatment could be justified by the variation of the enzymes in charge of metabolizing medications, especially those associated with cytochrome P450. Since genetic factors influence the phenotypic responses to drugs, researchers are involved in identifying schizophrenic genetic factors, which could impact responses and severe effects for commonly known neuroleptic drugs known as pharmacogenetics. In order to predict drug response at the personal level, genetic variants that determine drug effects need to be identified.Methods: We have chosen to investigate gene targets for risperidone and clozapine, two commonly administered drugs for the treatment of schizophrenia. The aim of this review is to contribute in the understanding of genetic influences on drug responses of risperidone and clozapine in schizophrenia. We reviewed original primary research articles, meta-analysis, and review publications on drug and gene interaction on the treatment of schizophrenia. Our main findings focused on schizophrenia, pharmacogenetics and cytochrome P450.Results and conclusion: After filtering our results to human species and English language, a total of 45 scientific articles were used for this review. A promising direction for future research in schizophrenia treatment lies behind the identification of the specific genetic contributors that affect drug response.

Current applications and limitations of surgical treatments for movement disorders.

Functional neurosurgery for the treatment of both psychiatric and neurological disorders has been performed regularly since the 1940s. However, misuse in the early days and the appearance of effective medical treatments, such as levodopa and neuroleptic drugs, greatly reduced surgical approaches over several decades. The development of a comprehensive model of basal ganglia pathophysiology in the 1990s facilitated the resurgence of functional neurosurgery, mainly for the treatment of levodopa-related motor complications in Parkinson's disease. This led first to the re-emergence of posteroventral pallidotomy and subsequently to deep brain stimulation. Thirty years on from this turning point, we find ourselves looking at a new scenario. Although deep brain stimulation is accepted worldwide and technical advances continue to improve this therapy, new questions and challenges such as long-term benefits and optimal targeting have emerged. In addition, new nonincisional tools used to perform ablative treatments, such as high-intensity focused ultrasound and gamma-knife, are challenging classical reluctance to therapeutic lesioning, and it remains to be determined how these approaches will fit into the array of movement disorder treatments. This review discusses the current clinical state of the art of functional neurosurgery in the treatment of Parkinson's disease, tremor, and dystonia. © 2017 International Parkinson and Movement Disorder Society.

Malignant Syndrome and Serotonin Syndrome in a General Hospital Setting: Clinical Features, Frequency and Prognosis.

Objective The differences in the frequency and clinical features of malignant syndrome (MS) and serotonin syndrome (SS) in same population have only rarely been reported. To report the frequency and clinical features of MS and SS in a general hospital setting. Methods The clinical and laboratory features of patients with MS and those with SS, who were consecutively admitted to Chiba Rosai Hospital, during the past 4.5 years were reviewed. Results Of the 2005 patients admitted, MS was observed in 16 patients (0.8%) and SS in 2 (0.1%). In the 16 patients with MS, the underlying disorder included depression (n = 5), and dementia or parkinsonism (n = 11). The underlying etiology of the 2 patients with SS was depression. In 5 patients, MS was difficult to distinguish from SS because of overlapping symptoms and signs and/or treatments with both neuroleptic and serotoninergic drugs. Of the 16 patients with MS, 1 died, 1 remained wheelchair-bound, 4 were able to walk with assistance, and 10 regained their ability to ambulate independently. The 2 patients with SS recovered after cyproheptadine therapy and were discharged on foot. Conclusion MS occurs more frequently than SS in the general hospital setting. Underlying aetiologies in patients with MS were more common due to dementia or parkinsonism than in patients with psychiatric disorders. The differential diagnosis of MS and SS is often difficult and the diagnostic sensitivities largely differ for each of the diagnostic criteria. As a result, the establishment of new diagnostic criteria that specifically focus on distinguishing MS from SS is therefore required.

Differential approaches to the treatment of acute psychosis due to the use of synthetic cannabinoids

Based on the study of 43 patients with acute psychosis due to the use of synthetic cannabinoids, the authors showed that the inclusion of neuroleptic drugs in the complex therapy increases the efficacy of therapy. In choosing a neuroleptic it is important to take into account not only the psychopathological structure of psychosis, but also the severity of somatic and neurological disorders associated with psychosis.

Fluvoxamine-induced neuroleptic malignant syndrome

Neuroleptic malignant syndrome (NMS) is an uncommon but life-threatening idiosyncratic drug reaction that occurs following neuroleptic drug exposure. The estimated incidence of NMS is though very low, resulting mortality rates range between 4% and 30%. There is increasing evidence that “Atypical” antipsychotics are associated with NMS that has a different character. NMS occurring with selective serotonin reuptake inhibitors' use is extremely rare, and it should be differentiated from serotonin syndrome. Here, we report a rare case of NMS induced by fluvoxamine.

Effect of chitosan nanoparticles on haloperidol drug-induced hepatotoxicity in albino rats Light and Electron Microscopic study.

Haloperidol (HP) is a widely used neuroleptic drug for the treatment of acute and chronic psychosis. The present study was carried out to investigate the effect of haloperidol on the liver of rats and the possible preventive effect of chitosan nanoparticle. Thirty two adult male rats were used in the present study. They were allocated into four groups. The first group served as control and was injected i.p. with 1mg/kg saline solution. The second group, each rat received a single (i.p.) injection of (2 mg/kg b.wt.) chitosan nanoparticles, each animal of third group given 0.3mg/ml/kg haloperidol while in the fourth group each rat received 0.3 mg/ml/kg haloperidol carried on nanoparticles daily for 21 days. Histological examination of liver sections of haloperidol- treated rats revealed destruction of the normal pattern of the hepatic lobules. The hepatic cells appeared with fatty degeneration and vacuolation of hepatocytes. The nuclei of hepatocytes exhibited noticeable signs of deterioration; pyknosis, karyorrhexis and karyolysis. Congestion of blood vessels was also detected and the portal areas were invaded by inflammatory lymphocytes. On the other hand, the liver sections of rats treated with haloperidol carried on nanoparticles showed minimizing the toxic effects of haloperidol alone. Electron microscopic investigation of hepatocytes of haloperidoltreated rats revealed conspicuous alterations, represented by aggregation of the rough endoplasmic reticulum in clumps and the mitochondria underwent swelling with obvious condensation of their matrices by materials that displayed high electron density and some of them lost their cristae. In conclusion: this study showed that when haloperidol carried on nanoparticles it decreased the destructive progress of haloperidol on the liver of rats.

Synthesis and SAR evaluation of novel thioridazine derivatives active against drug-resistant tuberculosis

The neuroleptic drug thioridazine has been recently repositioned as possible anti-tubercular drug. Thioridazine showed anti-tubercular activity against drug resistant mycobacteria but it is endowed with adverse side effects. A small library of thioridazine derivatives has been designed through the replacement of the piperidine and phenothiazine moieties, with the aim to improve the anti-tubercular activity and to reduce the cytotoxic effects. Among the resulting compounds, the indole derivative 12e showed an antimycobacterial activity significantly better than thioridazine and a cytotoxicity 15-fold lower.

Outcome of emergency surgery for severe neuroleptic-induced colitis: results of a prospective cohort.

The study evaluated the outcome of severe acute antipsychotic (neuroleptic) drug related colitis requiring emergency surgery. From 2009 to 2014, 20 patients underwent emergency surgery for acute and severe neuroleptic-related ischaemic colitis. Neuroleptic-induced colitis was defined as another cause besides inflammatory, infectious or ischaemic colitis with a relationship to treatment by antipsychotic drugs. The main drugs involved were cyamemazine (n=9, 45%), loxapine (n=5, 25%), haloperidol (n=4, 20%) and alimemazine (n=4, 20%). Most (n=14, 70%) patients presented with haemodynamic instability requiring massive resuscitation and vasopressive drugs. CT signs of digestive impairment were found in 13 (65%) patients having emergency surgery. The lesions were pancolonic in 40%; transparietal necrosis was found in 45% and 15% had colonic perforation. Twelve (60%) patients had total or subtotal colectomy and eight (40%) a segmental colectomy with colostomy or ileostomy in all cases. The postoperative mortality was 15% and morbidity was 70%, necessitating surgical reintervention in two (10%) patients. Of the 17 surviving patients, 11 (64.7%) had restoration of intestinal continuity after a median delay of 103days, with a postoperative morbidity rate of 36.3%. In the intent-to-treat population, the permanent stoma rate was 30%. The morbidity and mortality of surgery for neuroleptic-drug-induced colitis is higher than for colitis due to other causes. A better knowledge of this condition should lead to early diagnosis.

Neuroleptic Drugs and PACAP Differentially Affect the mRNA Expression of Genes Encoding PAC1/VPAC Type Receptors

Several lines of evidence suggest that pituitary adenylate cyclase-activating polypeptide (PACAP) is a neuropeptide playing an important role as a neuromodulator. It has been indicated that PACAP is associated with mental diseases, and that regulation of the PACAPergic signals could be a potential target for the treatment of such psychiatric states as schizophrenia. Recent studies have suggested that action of neuroleptic drugs is mediated not only by dopaminergic and serotonergic neurotransmission, but also via neuropeptides which may act both as neurotransmitters and as neuromodulators. The present study examines whether currently-used neuroleptics influence the action of PACAP receptors, whose expression is altered in a schizophrenic patient. Real-time polymerase chain reaction (PCR) was used to examine the effects of haloperidol, olanzapine and amisulpride on the expression of genes coding PAC1/VPAC type receptors in the T98G glioblastoma cell line, as an example of an in vitro model of glial cells. PAC1 mRNA expression fell after 24-h incubation with haloperidol or olanzapine; however the effect was not maintained after 72 h, and haloperidol even up-regulated PAC1 mRNA expression in a dose-dependent manner. All the examined drugs decreased VPAC2 mRNA expression, especially after 72-h incubation. Haloperidol (typical neuroleptic) was distinctly more potent than atypical neuroleptic drugs (olanzapine and amisulpride). In addition, PACAP increased PAC1 and VPAC2 mRNA expression. In conclusion, our findings suggest PACAP receptors may be involved in the mechanism of typical and atypical neuroleptic drugs.

The Harms of Antipsychotic Drugs: Evidence from Key Studies.

This safety assessment provides a detailed analysis of key studies and focuses on the six most widely used antipsychotic drugs. Lines of evidence include mechanisms of action, short-term treatment of psychosis, relapse prevention, early intervention in schizophrenia, long-term comparisons between first- and second-generation agents, and flexible treatment algorithms. Despite the diversity of study settings, several common features were seen. All the agents obstruct normal signaling through widely dispersed dopamine D2 receptors. Treatment failure or psychosis relapse was the most frequent outcome in most key studies, ranging from 38 to 93%. High discontinuation rates caused most trials to fail to demonstrate a substantial treatment benefit, or difference from an active comparator. Assessment of harm to the extrapyramidal motor system was confounded because of extensive neurological impairment from previous antipsychotic drug treatment measured at baseline, abrupt discontinuation effects, and high rates of concomitant medications to manage drug adverse effects. Claims that second-generation antipsychotic drugs have safety advantages over classical neuroleptic drugs and prevent relapse were not supported in these key studies. The extent of injury to and impairment of multiple body systems caused by antipsychotic drugs shows the need for a scientific, clinical, and regulatory reappraisal of the appropriate use of these agents.

Context-dependent efficacy of a counter-conditioning strategy with atypical neuroleptic drugs in mice previously sensitized to cocaine

RationaleWe have previously demonstrated that treatment with ziprasidone and aripiprazole selectively inhibit the development of behavioral sensitization to cocaine in mice. We now investigate their effects on a counter-conditioning strategy in mice and the importance of the treatment environment for this phenomenon. ObjectiveEvaluate the context-specificity of ziprasidone and aripiprazole on conditioned locomotion to cocaine and cocaine-induced hyperlocomotion and behavioral sensitization in a counter-conditioning strategy in mice. MethodsAnimals were sensitized with saline or cocaine injections in the open-field apparatus in a 15-day intermittent treatment and subsequently treated with vehicle, 5mg/kg ziprasidone or 0.1mg/kg aripiprazole paired to the open-field or the home-cage for 4 alternate days. Mice were then challenged with saline and cocaine in the open-field apparatus on subsequent days. ResultsWhile treatment with ziprasidone decreased spontaneous locomotion and conditioned locomotion alike, treatment with aripiprazole specifically attenuated the expression of conditioned hyperlocomotion to cocaine. Ziprasidone and aripiprazole had no effects on cocaine-induced conditioned hyperlocomotion observed during saline challenge after drug withdrawal. Treatment with either ziprasidone or aripiprazole when previously given in the cocaine-paired environment attenuated the subsequent expression of behavioral sensitization to cocaine. Animals treated with aripiprazole in the open-field, but not in the home-cage, showed a blunted response to cocaine when receiving a cocaine challenge for the first time. ConclusionsBoth neuroleptic drugs showed a context-dependent effectiveness in attenuating long-term expression of cocaine-induced behavioral sensitization when administered in the cocaine-associated environment, with aripiprazole also showing effectiveness in blocking the expression of acute cocaine effects.

Psychiatric Disorders in Puerperium

Introduction: Post partum psychiatric illness was initially conceptualized as a group of disorders specifically linked to pregnancy and childbirth and thus was considered diagnostically distinct from other types. More recent evidence suggest that Post partum psychiatric disorder is virtually indistinguishable from psychiatric disorders that occur at other times during a woman’s life. A wide variety of disorders are seen. Recognition of disorders for the mother-infant relationship is important, because these have pernicious long-term effects but generally respond to treatment.Objective: The objective of this review is to highlight the different type of psychiatric disorders in the puerperium and their management.Materials and Methods: Literature of reputed journals were used to prepare this article with the help of pshychiatric consultant.Results: Psychiatric disorder in puperium has got different severity. Commonly encountered disorders are: Maternity blues, Post natal depression, Post partum psychosis. Most common is related to manic depression, in which neuroleptic drugs should be used with caution. Eighty five (85%) of women experiences mood changes in postpartum. About 10%-15% of women develops post partum depression. 0.1% -0.2% experience postpartum psychosis. 4,00000 children are born to depressed mothers every year.Conclusion: The obstetrics team should alert both to possible interaction between psychological and obstretics factors and to the range of psychiatric disorders that may occur during pregnancy and puperium. The obstetrics and psychiatric teams should work together to improve their services locally and high light the need for greater service provision every where ic stress disorder, obsessions of child harm, and a range of anxiety disorders all require specific psychological treatments. Postpartum depression necessitates thorough exploration. Cessation of breastfeeding is not necessary, because most antidepressant drugs seem not to affect the infant. Controlled trials have shown the benefit of involving the child’s father in therapy and of interventions promoting interaction between mother and infant. Owing to its complexity, multidisciplinary specialist teams have an important place in postpartum period. It should have clinical priority those are suffering from psychiatric problem during puperium as they are in crucial situation. It is important to recognize earliar to avoid undesirable consequences, which are harmful both for mother and infant.. According to severity patient may need counseling, social support, sometimes patient may need hospitalization in severe cases. There are several traditional methods worldwide sometimes they are beneficial and sometimes harmful to mother and infant.Bangladesh J Obstet Gynaecol, 2013; Vol. 28(1) : 38-43

Effects of Music Therapy on Drug Therapy of Adult Psychiatric Outpatients: A Pilot Randomized Controlled Study.

Objective: Framed in the patients’ engagement perspective, the current study aims to determine the effects of group music therapy in addition to drug care in comparison with drug care in addition to other non-expressive group activities in the treatment of psychiatric outpatients.Method: Participants (n = 27) with ICD-10 diagnoses of F20 (schizophrenia), F25 (schizoaffective disorders), F31 (bipolar affective disorder), F32 (depressive episode), and F60 (specific personality disorders) were randomized to receive group music therapy plus standard care (48 weekly sessions of 2 h) or standard care only. The clinical measures included dosages of neuroleptics, benzodiazepines, mood stabilizers, and antidepressants.Results: The participants who received group music therapy demonstrated greater improvement in drug dosage with respect to neuroleptics than those who did not receive group music therapy. Antidepressants had an increment for both groups that was significant only for the control group. Benzodiazepines and mood stabilizers did not show any significant change in either group.Conclusion: Group music therapy combined with standard drug care was effective for controlling neuroleptic drug dosages in adult psychiatric outpatients who received group music therapy. We discussed the likely applications of group music therapy in psychiatry and the possible contribution of music therapy in improving the psychopathological condition of adult outpatients. In addition, the implications for the patient-centered perspective were also discussed.

Нейролептические средства и мелатонин

Как показывают экспериментальные данные, гормон мозговой железы эпифиза мелатонин оказывает модуляторное влияние на центральную дофаминергическую передачу и в некоторых ситуациях усиливает действие антипсихотических средств. С другой стороны, мелатонин способствует ограничению различных побочных эффектов нейролептиков. Предполагается целесообразность апробации их сочетанного применения с гормоном в клинической практике для терапии психотических расстройств.