Biperiden and piroheptine do not affect the serum level of zotepine, a new antipsychotic drug

Article Abstract:

Medications used to treat the symptoms of psychosis and mental retardation often cause side effects that involve the extrapyramidal motor system, and result in twitching and related involuntary motions. To counteract these adverse effects, anticholinergic drugs, which suppress the transmission of nerve signals, are often prescribed along with antipsychotic drugs. However, in addition to possessing side effects themselves, anticholinergics such as biperiden and piroheptine have another undesirable effect, in that they bring about a decrease in the blood levels of the antipsychotic drugs, leading to a loss of efficacy in controlling psychotic symptoms. The effects of anticholinergic drugs on the bioavailability of a new antipsychotic, zotepine, were studied in 21 schizophrenic or mentally retarded patients. Zotepine, a tranquilizer with effects similar to the more commonly prescribed chlorpromazine, has been found to be effective in the treatment of schizophrenia. After two weeks of taking a constant dose of zotepine, the patients were also given biperiden in 6 milligrams (mg) daily doses for another two weeks. Following that sequence, zotepine was again taken alone for two weeks, after which 12 mg per day of piroheptine was added for two more weeks. Blood levels of zotepine were measured at appropriate points, and psychotic symptoms of the 15 schizophrenic patients were evaluated. Blood levels zotepine were not affected by either of the anticholinergics, which produced only mild side effects in a few cases. The results demonstrate that biperiden and piroheptine are appropriate anticholinergics to reduce the extrapyramidal side effects caused by zotepine and other antipsychotic drugs. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Schizophrenia, Extrapyramidal disorders, Biperiden

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Aggressiveness, anxiety and drugs

Article Abstract:

In acute mental disorders, aggression and anxiety are the most common symptoms requiring psychopharmacological intervention. Clinical observations have lead to the conclusion that the same drugs (antipsychotics, beta-blockers, major and minor tranquilizers, sedative antidepressants, hypnotics, analgesics, and anticonvulsants) tend to relieve both symptoms. Conversely, both anxiety and aggression can be induced by stimulants, catecholamines, and antidepressants, which activate noradrenergic pathways (sequence of reactions associated with neural excitation). However, exceptions occur occasionally; if higher than standard doses are given, or there is damage to the central nervous system, paradoxical reactions may occur. Both animal and human research have shown that fear and fight are reversible phenomena and that anxiety and aggression are both rooted in the basic activity of the central nervous system. Psychosocial findings support this theory and indicate that faith, love, group identification, exercise, and caressing, diminish aggression and anxiety, while isolation, helplessness, frustration, threat, pain and territorial invasion have triggering effects. Exceptions exist, but a general rule of thumb can be assumed: if a drug has anti-anxiety effects it will also have anti-aggressive effects. (Consumer Summary produced by Reliance Medical Information, Inc.)

Observations, Anxiety, Aggressiveness (Psychology), Psychopharmacology

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