The use of atypical antipsychotics for dependence on alcohol is one of the most controversial issues in medicine. Tiapridal is a rare exception - it has long been used in narcology, and large-scale studies have successfully shown its effectiveness in the treatment of alcohol withdrawal, delirium, alcoholic psychosis and other syndromes.
Tiapridal
Tiapridal since the 90's. XX century has established itself as an effective drug for the treatment of alcohol withdrawal( of varying complexity), including in complex therapy, as well as various forms of alcoholic psychopathy.
Today, this drug is listed in official standards for the treatment of alcohol( and opioid) dependence in Western countries - the United States, Germany, France, the United Kingdom. In Russia, extensive trials of tiapridal in Moscow research institutes began in 1992, but the properties of the drug are still being studied.
Tiapridal is an atypical neuroleptic from a group of benzamides that are approved for use in Russia. The main biologically active substance in the composition - Tiaprid - was first synthesized in France in 1972. And today the French company Sanofi-Winthrop Industrie remains the main producer of Tiapridal and its supplier to the Russian market.
Buy tiapridal in Russian pharmacies can be priced from 1100 rubles and above - so much is a package of 20 tablets and a package of 12 ampoules.
Composition and Form Release
The main substance in the formulation is thiaprid hydrochloride. The tablets also contain auxiliary substances - mannitol, cellulose, magnesium stearate, etc. A solution of thiapridal for injections is made on the basis of water and sodium chloride.
On the Russian shelves, you can find the following "tiapridalnye" release forms and dosage of neuroleptic:
- tablets, 20 pieces( 2 blisters for 10 dragees of tiapridal);
- ampoules, 12 pieces( solution for injection with thiapridal).
Pharmacological action and pharmacodynamics
Pharmacological action in the French drug is neuroleptic. Tiapridal acts as a hypnotic, soothing and anesthetic. Its pharmacological action is based on the blocking of dopamine receptors of subtypes D2 and D3( D1 receptors are not affected) in different parts and regions of the brain:
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- mesolimbic and mesocortical neural pathways - antipsychotic action);
- reticular formation( neural complex) of the brain - sedative effect;
- trigger zone of vomiting center in medulla oblongata - antiemetic effect;
- hypothalamus - body temperature equalization.
Due to this, Tiapridal helps to remove a whole complex of mental, neurological and somatovegetative complications in alcoholics. It weakens nervous tension and anxiety, normalizes sleep( at different periods of the disease), relieves attacks of aggression, significantly reduces seizures and headache.
As part of complex therapy, Tiapridal is able to enhance the effect of hypnotic drugs, analgesics, tranquilizers, NSAIDs.
Pharmacokinetics
After the ingestion of Tiapridal into the body, the drug is distributed fairly quickly throughout the body - within an hour. At a single dosage of 200 mg - tablets - the maximum concentration of tiaprid in the blood plasma is fixed in an hour. With injection, this time is halved.
Tiapridal is able to penetrate blood-brain and placental barriers, but it does not accumulate in the body. In animals, the preparation Tiapridal is able to penetrate breast milk; in humans, this ability of neuroleptics has not yet been studied.
Bioavailability( i.e., ability to digest) in thiapridal is 75%, if taken directly before meals, bioavailability increases by 20%.
Indications and instructions for use
In narcology, Tiapridal is used to treat a wide variety of alcohol dependence disorders:
- withdrawal syndrome of varying severity;
- alcohol withdrawal syndrome;
- delirium( white fever);
- alcoholic psychoses;
- correction of emotional, somatoneurological, psychiatric disorders;
- is an anti-relapse treatment.
Tiapridal is especially widely used to relieve aggression in severe alcoholics, to get rid of tremors( in complex therapy), to restore sleep and to treat other symptoms.
The dosage and how to take depends on the diagnosis and age of the patient. In the treatment of alcoholism, adult patients usually start with the lowest effective dose of thiapridal, gradually increasing it.
- Tablets. The classical daily dose in the treatment of withdrawal and withdrawal of aggression with alcoholism is 200-300 mg / day. When treating white fever, the daily "portion" of the drug can be increased to 600 mg / day. Standard therapeutic course - 1-2 months. For elderly patients - 50 mg tiapridala 2 times a day( then gradually increase the dose to a maximum of 300 mg).
- Solution for injections( intravenous and intramuscular).The standard dosage of neuroleptic is 200-400 mg per day. With white fever( or in the prodromal period) it is allowed to inject the drug every 4-6 hours, a daily "dose" of 400-1200 mg, maximum - 1800 mg.
Contraindications
Among atypical antipsychotics, "Tiapridal" is considered a fairly safe drug, but nevertheless, it has an impressive list of contraindications:
- Prolactin-dependent tumors( pituitary or breast cancer);
- pheochromocytoma - tumor of adrenal medulla;
- first trimester of pregnancy and lactation;
- hypersensitivity to the active substances of the drug;
- hypertensive crisis;
- marked renal failure.
When tyapridal tablets are taken, the combination of an antipsychotic with several groups of drugs is strictly prohibited: dopaminergic agonists, agents affecting the heart rhythm, some neuroleptics( chlorpromazine, thioridazine, levomepromazine, trifluoperazine, amisulpiride, etc.).
Side effects of
Various side effects of therapy are a typical feature of neuroleptics, especially atypical ones. Although Tiadipadal, in comparison with other medicines from this group, has a smaller set of "pobochek", during treatment, unpleasant symptoms may appear: from the side of the nervous system, endocrine and cardiovascular. All signs disappear immediately after discontinuation of reception, and also are easily stopped with the help of the simplest medicines.
Side effects:
| Body system | Side effects |
|---|---|
| Central nervous( CNS) |
|
| Endocrine |
|
| Cardiovascular |
|
Special instructions for
To avoid undesirable consequences when taking a French antipsychotic, "Tiapridal" should be administered with caution to certain groups of patients. And also carefully and accurately combine with other medicines.
Special care must be taken when administering thiapridal to the following:
- patients with epilepsy;
- with severe cardiovascular ailments;
- with chronic renal failure;
- patients of advanced age.
Patients should be monitored carefully while taking thiapridal and cholinesterase inhibitors, pressure boosters, CNS depressants( morphine derivatives, hypnotics, etc.).
Reviews
Tiapridal is quite popular among drug treatment specialists and is one of the most sought after neuroleptics for the treatment of alcohol dependence and the treatment of alcoholic psychopathies. The French drug is used repeatedly in clinical studies( both within the whole institutions and individual hospitals), becoming a central topic for scientific publications.
In this case, as the narcologists emphasize, when using thiapridal, the risk of adaptation and adaptation of the patient's organism to the French antipsychotic is minimized.
Patients especially note the effectiveness of "Tiapridal" when removing aggression from alcoholics:
"My husband drinks very often, but refuses from full treatment. Recently began psychosis, beats, becomes uncontrollable, sometimes just scary for their lives. The doctor persuaded him into the thiapridal course, and the effect is obvious! Attacks of aggression are gone, he is not so much drawn to alcohol. "
Despite a rather impressive list of atypical antipsychotics( including those from the benzamide group), there are practically no analogues of Tiapridal. The main drug-analogue is "Tiaprid"( tablets and solution), its price is comparable to the French drug.