Thioridazine: Uses And Side Effects Of This Psychotropic Drug
Thioridazine is a drug that acts as an antipsychotic (first generation) and as an anxiolytic, reducing anxious and psychotic symptoms. It is mainly used for schizophrenia in the event that other antipsychotic drugs have not been beneficial to the patient.
However, its indications go further, and it is also used for behavioral disorders, psychotic depression and anxiety, among others. We will also learn about its general characteristics, its mechanism of action, its pharmacokinetics and its adverse reactions.
Thioridazine is an anxiolytic and antipsychotic drug; specifically, It is a phenothiazine (a group of antipsychotic drugs). Chemically it is similar to mesoridazine (one of its metabolites).
Thioridazine is indicated for the treatment of some psychotic disorders such as schizophrenia, anxiety associated with depression, behavioral disorders in children and dementia. What it does is reduce the abnormal excitation of the brain.
In addition, it is the phenothiazine with fewer extrapyramidal effects, that is, movement-related disorders, which arise as a type of side effect. However, Its sedative and anxiolytic effects are important
Contraindications of thioridazine are: having hypersensitivity to thioridazine itself or to other phenothiazines, severe depression in the CNS (Central Nervous System), comatose states, as well as having severe hypotension or cardiac hypertension.
Mechanism of action of this drug
The mechanism of action of thioridazine is blocking postsynaptic dopamine D2 receptors in the mesolimbic system of the brain The blockade also explains the extrapyramidal effects observed with thioridazine intake.
On the other hand, thioridazine also blocks cholinergic (acetylcholine) and alpha-adrenergic (adrenaline) receptors, which leads to side effects such as sedation, muscle relaxation and cardiovascular effects (for example hypotension, alterations in the electrocardiographic profile and reflex tachycardia).
Indications: disorders in which it is used
Thioridazine is an antipsychotic that is indicated for the treatment of psychotic disorders, such as schizophrenia or psychotic depression. In some cases it is also used for severe behavioral disorders in children (for example aggression and hyperexcitability), difficulties maintaining attention, dementia and anxiety associated with depressive disorder.
Specifically, thioridazine is used to control the manifestations or symptoms of psychotic disorders In the case of schizophrenia, thioridazine is used as an alternative treatment in case 2 other drugs have not previously produced good results or there are occasionally serious side effects in the patient. It is also indicated for sleep disturbances and fears in the elderly.
Regarding depression, It is indicated for moderate or severe short-term depression with accompanying symptoms such as anxiety.
Thioridazine should be used very cautiously in patients with Parkinson’s disease or liver disease.
Side effects
The adverse reactions that thioridazine can cause, like other phenothiazines, are major cardiovascular reactions It is for this reason that thioridazine is prescribed to patients who have not responded to other types of antipsychotic drugs.
Also may cause sedation, dry mouth, vertigo, orthostatic hypotension, skin rashes, vision disorders ejaculation disorders, photosensitivity, urinary incontinence and galactorrhea (occasional).
The use of thioridazine is not recommended during pregnancy and lactation. If driving, you should act with great caution, since the drug can cause important effects such as drowsiness and decreased reaction capacity.
It can also cause visual disturbances (blurred vision, decreased night vision and scotoma), although these may disappear if thioridazine is withdrawn early. However, vision does not always improve, despite discontinuation of the drug, as has been seen in some cases.
Some data
Studies carried out with thioridazine showed that 60% of patients taking the drug suffered sexual dysfunction (compared to 25% of patients treated with other antipsychotics).
Another side effect that may appear, tardive dyskinesia, occurs in 4% of cases treated with thioridazine, annually (during the first 5-6 years of treatment).
Pharmacokinetics
Thioridazine is administered orally and is rapidly absorbed. The therapeutic effects are usually maximum 6 weeks after starting treatment with thioridazine Phenothiazines such as thioridazine cross the blood-brain barrier and are distributed throughout all body tissues.
It also crosses the placenta and is excreted in breast milk, so there should be great caution regarding its use.
How is it taken?
thioridazine It is usually taken as tablets orally, generally 2 to 4 times a day (between 50 and 800 mg/day/orally). It is recommended to take it at the same time every day, and consult the prescription instructions for any questions that have not been previously resolved by the doctor or pharmacist.
Generally, the doctor prescribes thioridazine at a low dose and gradually (and according to the patient’s needs) increases it gradually, until the symptoms are controlled. Later, with symptoms controlled, the doctor will likely reduce the dose.
Although thioridazine can help control or alleviate certain symptoms, it does not “cure” any pathology; that is, always It will be advisable to follow psychological treatment combined with pharmacological treatment Furthermore, having a family support network (and friends) will always be important for the patient’s treatment and improvement.
