Droperidol: Uses And Side Effects Of This Antipsychotic
Antipsychotics or neuroleptics are one of the best-known types of psychotropic drugs, after antidepressants and anxiolytics. It is a type of substance that combats the symptoms of disorders as disabling and severe as schizophrenia, allowing those who suffer from it to control their symptoms and maintain a normative life.
But those formerly called major sedatives can also have other uses, in some cases these are even the most common. This is the case of droperidol an antipsychotic that we are going to talk about here.
Droperidol is a drug with psychoactive properties that belongs to the group of antipsychotics or neuroleptics.
This substance, derived from tetrahydropyridine and which is part of the butyrophenones is considered one of the typical or first generation antipsychotics.
These are drugs that are highly effective in the treatment of hallucinatory and delusional symptoms typical of the positive or productive symptoms of schizophrenia and other psychotic-type problems, but they have almost no effects on the negative ones (cognitive, emotional and language impoverishment). , among others) and that have a high potential to generate annoying and undesirable side effects.
In the case of droperidol, it is a highly potent drug but whose effects are short-lived (usually between two and four hours).
However, Beyond schizophrenia, droperidol is well known in other areas that are more medical than psychiatric It has a relevant anesthetic and analgesic effect, as well as an antiemetic (makes vomiting difficult or impossible). It is a substance with sedative properties, which is metabolized in the liver and eliminated through urine.
Its main presentation is in the form of injectables , which are administered intravenously or intramuscularly, and are generally used in emergency cases. Previously, there was an oral presentation, but doubts and the long-term danger of the drug in relation to coronary events caused the pharmaceutical company itself to withdraw this form of presentation from the market.
Droperidol affects the body through a mechanism of action based on dopamine antagonism blocking the receptors of this neurotransmitter nonspecifically throughout the brain.
This fact makes it effective in the treatment of hallucinatory and delusional symptoms as well as the agitation typical of psychotic outbreaks, which are related to an excess of dopamine in the mesolimbic pathway.
However, Its non-specific action throughout the brain makes it likely that side effects will appear by decreasing this day also in areas where there is no excess and even in which there is a deficit (as occurs in the mesocortical pathway in people with negative symptoms).
It also affects the receptors in the area postrema, something that is linked to its ability to inhibit vomiting. Fortunately, and unlike other antipsychotics, it does not present effects at the level of acetylcholine or histamine (an effect that could generate other side effects). It does have an effect on adrenergic receptors, although it is not especially powerful.
Indications and uses of droperidol
Droperidol is an antipsychotic or neuroleptic drug so that one of its indications is the treatment of schizophrenia and other psychotic disorders.
However, its effects on the body last a short time, which makes it (along with its potential to generate arrhythmias and cardiac events) not optimal for chronic treatment. Instead of that, It is used to treat psychotic outbreaks in the acute phase and in emergency situations and is generally not a first-line drug.
Where this drug is most commonly used, in reality, is in surgery : Its powerful analgesic and sedative effects are used for sleep induction and as an adjuvant drug for anesthesia (whether general or local). Likewise, it is also used to reduce the usual previous anxiety before this type of intervention.
Its antiemetic effect It also makes it useful for treating post-chemotherapy nausea. They are also used to treat nausea and vomiting after these interventions.
Side effects
Although the use of droperidol is useful and relevant in the treatment of various problems, the truth is that, as with other drugs, it can also cause relevant side effects and even risks to one’s physical integrity.
These side effects are not common, especially if use is limited to sporadic situations, but they should be taken into account.
Among the most common side effects are: sedation and drowsiness , something useful in certain situations but which can be annoying and disabling for whoever uses it. It is also common to cause arterial hypotension and tachycardia, as well as dizziness.
It can also cause hallucinations, excesses of antidiuretic hormone or alterations in the levels of the different components of the blood (in terms of red blood cells, leukocytes or platelets) that can endanger survival.
Neuroleptic malignant syndrome may also appear with fatal potential (this being, together with the aforementioned risk of leukopenia among others, one of the reasons why antipsychotics are introduced little by little and with great medical control).
It can also cause, in high doses, Parkinsonian-type alterations, agitation, catalepsy, fever, alterations of consciousness such as stupor, convulsions, coma or sudden death.
A highly relevant side effect is the fact that it lengthens the QT interval, something that can cause cardiac alterations, such as arrhythmias In extreme cases it can cause cardiac arrest.
Contraindications
As we have seen, there are multiple risks that the use of droperidol can have, something that makes it necessary to take into account that There are different types of populations that are contraindicated for this drug
To begin with, it should be avoided by those people who are allergic to this drug or its components. Pregnant and lactating women should also avoid it, since there is not enough data regarding its safety for fetuses and infants. Pregnant women who plan to become pregnant in a short time should discuss with their doctor the suitability of using this drug or not.
Great caution should be taken when taking other drugs. Alcohol, depressant substances, some antibiotics, antihypertensives or some drugs that alter the ability to clot blood may be examples of elements that can interact dangerously with droperidol. Other drugs such as glucocorticoids are directly contraindicated.
In general, the use of this medication together with others should be consulted with the doctor, given the risk of interaction.
People with angina pectoris, previous heart attacks or heart problems should avoid it , and those with liver or kidney problems and failure should take special caution. It is contraindicated in subjects with epilepsy or a history of it, as well as in people with Parkinson’s disease or severe depression.
People with low levels of potassium or sodium in the blood, bradycardia or arrhythmias or with adrenal tumors are contraindicated. Also in insulin-dependent diabetics, special care should be taken
