Pharmacological group of Mellaril
The nosological classification (ICD-10) of Mellaril
F10-F19 Mental and behavioral disorders due to psychoactive substance use
F17.3 abstinent condition caused by tobacco use
F31.9 Bipolar affective disorder, unspecified
F42 Obsessive-compulsive disorder
F48.9 Neurotic disorder
R45.1 Restlessness and agitation
Mellaril or Melleril) is a piperidine typical antipsychotic drug belonging to the phenothiazine drug group and was previously widely used in the treatment of schizophrenia and psychosis
Characteristic of Mellaril
Neuroleptic, piperidine phenothiazine.
Pharmacology of Mellaril
Mode of action — antipsychotic, sedative.
1. Inhibits the dopaminergic and adrenergic transmission (especially in the reticular formation of the brain).
2. The drug blocks peripheral m-cholinergic receptors.
3. Mellaril reduces hyperactivity of the autonomic nervous system.
4. The drug has a depressing effect on psychomotor functions. 5. The drug is effective for reducing the excitation, increased mobility, affective stress, agitation.
5. Antipsychotic effect combined with a sedative effect.
6. Mellaril does not cause lethargy, weakness and emotional indifference.
7. The drug exhibits an activating action.
8. The drug is rapidly and completely absorbed from the gastrointestinal tract. Cmax achieved within 1-4 hours.
9. Humanity excreted by the kidneys and the bile.
Indications for use of Mellaril
Schizophrenia, manic-depressive psychosis; neuroses, accompanied by fear, tension, excitement, compulsions; tics, withdrawal syndrome in chronic alcoholism and substance abuse, the state of agitation of various origins.
Contraindications of Mellaril
1. Hypersensitivity, severe cardiovascular disease (decompensated chronic heart failure, severe hypertension or hypotension), marked inhibition of CNS functions and comatose states from any cause; 2. TBI, progressive system of the brain and spinal cord diseases;
3. Concomitant use with drugs that prolong the interval QT;
4. Congenital lengthening of the interval QT, arrhythmia (including history);
5. Simultaneous reception of inhibitors or substrates isoenzyme SYP2D6;
6. Porphyria, pregnancy, breast-feeding, child age (up to 2 years).
Restrictions apply of Mellaril
Alcoholism (predisposition to hepatotoxicity), pathological changes in the blood (impaired hematopoiesis), breast cancer (as a result of induced phenothiazine prolactin increase the potential risk of disease progression and resistance to the treatment of endocrine and cytostatic drugs), angle-closure glaucoma, prostatic hyperplasia with clinical manifestations , liver and / or renal failure, gastric ulcer and duodenal ulcer (in the period of exacerbation); diseases accompanied by an increased risk of thromboembolic complications; Parkinson’s disease (amplified extrapyramidal effects); epilepsy; myxedema; chronic diseases accompanied by respiratory disorders (especially in children); Reye syndrome (increased risk of hepatotoxicity in children and adolescents); cachexia, vomiting, advanced age.
Side effects of Mellaril
From the nervous system and sensory organs: drowsiness (especially when taking high doses early in treatment, usually decreases with continued therapy or dose reduction), fainting, confusion, psychomotor disorders, tardive dyskinesia, agitation, excitation, insomnia, hallucinations, strengthening psychotic reactions dystonic and parkinsonian extrapyramidal disorders, emotional disorders, thermoregulation, reduced seizure threshold, photophobia, blurred vision.
From the digestive tract while using Mellaril: sialoschesis, hypertrophy of papillae language, reduced / increased appetite, indigestion, nausea, vomiting, constipation / diarrhea, paralytic ileus, cholestatic hepatitis.
From endocrine system: galactorrhea, breast engorgement, amenorrhea, dysmenorrhea, hyperprolactinemia, gynecomastia, false positive pregnancy tests, increase in body weight.
Cardio-vascular system and blood (blood, hemostasis): decrease in blood pressure, tachycardia, nonspecific ECG changes, inhibition of bone marrow hematopoiesis (agranulocytosis, leukopenia, granulocytopenia, eosinophilia, thrombocytopenia, aplastic anemia, pancytopenia).
From the respiratory system: bronhospastic syndrome, nasal congestion.
With the genitourinary system while using Mellaril: the paradoxical urinary retention, dysuria, loss of libido, sexual dysfunction (including retrograde ejaculation), priapism.
Allergic reactions: skin rash (including erythematous), angioedema, exfoliative dermatitis.
Other: peripheral edema, in the parotid gland swelling, melasma (with prolonged use at high doses). When receiving neuroleptics phenothiazine series were cases of sudden death (including due to cardiac causes); possible prolongation of the interval QT — the risk of developing ventricular arrhythmias (especially against the background of the initial bradycardia, hypokalemia, elongated QT).