Levomepromazine: Uses And Side Effects Of This Drug
Throughout history there have been many drugs that have been developed in order to combat the symptoms and alterations caused by many disorders and alterations of the psyche. Antidepressants and anxiolytics are unfortunately not uncommonly used, given the high prevalence of the problems they treat.
Another problem, well known and generating a high level of suffering, is schizophrenia. And fortunately for her there are also drugs that contribute to the treatment of her symptoms. Among them is levomepromazine which we are going to talk about next.
It is called levomepromazine, a highly potent psychotropic drug classified as antipsychotic or neuroleptic drug which is part of the chemical family of phenothiazines.
As such, levomepromazine It is effective in treating the symptoms of schizophrenia and other psychotic disorders, especially in the productive clinic such as delusions, hallucinations and agitation.
Among antipsychotics, this substance is part of the so-called typical, classic or first generation antipsychotics.
This subtype of antipsychotic was the first to be synthesized, and they are characterized because they are highly effective in treat positive psychotic symptoms (read that which introduces elements into the subject’s psychic functioning, such as the aforementioned hallucinations or delusions) despite the fact that they unfortunately produce annoying and even dangerous secondary symptoms.
Besides, They have no effect on and can even worsen negative symptoms or that which is characterized by the deterioration or loss of previously present functionalities: impoverishment of language, abulia and emotional flattening and impoverishment of thought or alogia.
Levomepromazine has a sedative and tranquilizing action, as well as an analgesic, and is one of the oldest antipsychotics. Also has antihistamine and antispasmodic properties It is absorbed in the intestine, metabolized mainly in the liver and excreted through urine.
It can be found in different presentations including tablets and drops for oral administration or in the form of injectables to be administered intravenously. One of the main commercial brands is Sinogan.
Mechanism of action
Levomepromazine acts in our brain by altering the body’s chemistry, causing an effect on the levels of neurotransmitters that our neurons emit.
Specifically, the action of this drug occurs because we are facing a dopaminergic antagonist which blocks the D2 receptors of the brain neurons in such a way that the neurons stop capturing it to a large extent and its levels are reduced.
This is very useful in the treatment of agitation and positive symptoms, since it has been seen that in schizophrenia there is an excess of dopamine in the mesolimbic pathway of the brain and that This excess is linked to the appearance of agitation, hallucinations and delusions
However, the action of this drug and that of other classic neuroleptics is nonspecific, in such a way that dopamine levels also decrease in brain areas that do not have any excess of dopamine or that may even have a deficit (something that precisely occurs in the mesolimbic pathway when there are negative symptoms), in such a way that secondary symptoms such as the motor or sexual symptoms mentioned above may appear.
In addition to that also alters histamine, adrenaline and acetylcholine levels something that can also cause harmful secondary symptoms.
Main medical uses
As one of the typical antipsychotics that it is, levomepromazine’s main indication is the treatment of all those conditions in which psychotic symptoms occur. Its most relevant indications are therefore schizophrenia, acute psychoses and paranoid states But schizophrenia and psychotic disorders are not the only indications for this drug.
It also has an important effect on algesia or sensitivity to pain, being a powerful analgesic that allows treating pain of moderate to severe intensities from different conditions.
In this sense, Another of its most relevant indications is found in palliative care , specifically in those patients who are in the terminal phase. Levomepromazine helps treat agitation, delirium, and states of confusion and nervousness in these patients, especially when they are associated with pain.
It has even been used in some states of anxiety, depression, bipolar episode or obsessive-compulsive disorder, although today there are a large number of much safer and more useful drugs for these conditions.
Side effects
Although it is effective in treating various conditions, the truth is that levomepromazine can cause really annoying side effects or even be dangerous to the person’s physical integrity (although these are less frequent).
Among the most common we can find drowsiness or weight gain Other less common side effects may be hyperglycemia and modification of glucose tolerance, the provocation of tardive dyskinesia or involuntary repetitive movements, generally of the chewing type. It can cause sexual dysfunctions such as erectile dysfunction or loss of libido, as well as hyperprolactinemia.
In some cases it also promotes breast growth in men or lack of menstruation. Hyperglycemia or hyponatremia (low blood sodium levels), as well as antidiuretic hormone disturbances, may be possible. Also seizures and parkinsonian symptoms.
Some more dangerous reactions They may include possible pulmonary embolisms, thrombosis, jaundice, agranulocytosis or leukopenia (these two conditions that involve a decrease in the levels of essential elements in the blood, respectively granulocytes and leukocytes).
It can cause liver damage, heart rhythm disturbances such as arrhythmias, bradycardias or tachycardias, enterocolitis (with fatal risk) or the life-threatening neuroleptic malignant syndrome.
Contraindications
The adverse effects and changes that levomepromazine generates in the body can be dangerous for some sectors of the population, who will be contraindicated with this drug.
First of all, it should be noted that this drug is contraindicated for those who have or have had an allergy to it or any of its components.
Pregnant and lactating women should also avoid it or at least consult with the doctor about the suitability of consuming it or changing drugs if necessary.
It is contraindicated in patients with glaucoma, Parkinson’s or porphyria. Its administration with other drugs should be avoided or consulted (especially if levodopa is consumed), and its consumption with alcohol is contraindicated.
It is contraindicated or the condition of patients who have had cardiovascular, renal or hepatic alterations must be monitored (especially if renal or hepatic failure has occurred.
It is also not recommended in diabetic patients (since it affects blood glucose levels) or subjects with problems such as thrombi or embolisms. Epileptic patients should be monitored and controlled given the risk of generating new seizures or reducing the activation threshold that generates seizures.
It should be avoided in the elderly, especially if they suffer from any type of dementia because it can increase the probability of premature death.
