FROM "MAJOR TRANQUILIZERS" TO ANTIPSYCHOTIC DRUGS

Chandrajeet Kumar, Mohammad Irfan and Akhilesh Kr. Singh

University Of Lucknow
INTRODUCTION
A tranquilizer is a drug that acts on the central nervous system and is used to calm, decrease anxiety, or help a person to sleep. Two types or classes of tranquilizers: major tranquilizers and minor tranquilizers. Antipsychotics are drugs that have a specific sedative effect, and which improve the attitude and calm the behavior of psychotic patients. Antipsychotics are among the biggest selling and most profitable of all drugs, generating $22 billion in global sales in 2008. Antipsycotics are subdivided into two groups: A first generation of antipsychotics, known as typical antipsychotics, was discovered in the 1950s. Medications for mental illnesses were first introduced 1950s with the tyical antipsychotic chlorpromazine. Most of the drugs in the second generation, known as atypical antipsychotics.[1] The atypicals are "only moderately more efficacious". The first atypical antipsychotic is clozapine.[2]

HERBS FOR HEALTH:NATURAL TRANQUILIZERS

Kawain is a tranquilizer obtained from Piper methysticum (kava kava). Nicotin from tobacco(nicotiana sylvestris) plants have been used in tranquilizer guns. An element found in the valerian rootstock called valepotriates causes potent sedative actions on the central nervous system. Damiana is a shrub that is effectual in treating various anxieties. It is one of the best herbs for anxiety. It has been used as tonic by both male and females and also to promote hormonal production and or increase sexual potency. Chamomile i s one of the safest herbs in the line of anti anxiety herb. German chamomile and Roman chamomile are two varieties of them. Ginseng has been used for various ailments but most effectively as an anti anxiety herb.

SYNTHETIC PATHWAYS
chlorpromazine, Thorazine - a drug (trade name Thorazine) derived from phenothiazine that has antipsychotic effects and is used as a sedative and tranquilizer.

RISKS AND SIDE EFFECTS

Antipsychotics are associated with a range of side effects.[6] Antipsychotics, particularly atypicals, appear to cause diabetes mellitus and fatal diabetic ketoacidosis. Antipsychotics increase the likelihood of a fatal heart attack, with the risk of death increasing with dose and the length of time on the drug . Withdrawal symptoms from antipsychotics may emerge during dosage reduction and discontinuation. Withdrawal symptoms can include nausea, emesis, anorexia, diarrhea, rhinorrhea, diaphoresis, myalgia, paresthesia, anxiety, agitation, restlessness, and insomnia. Side effects from antipsychotics can be managed by a number of different drugs. For example, anticholinergics are often used to alleviate the motor side effects of antipsychotics.

DEVELOPMENT HISTORY
The original antipsychotic drugs were happened upon largely by chance and then tested for their effectiveness. The first, chlorpromazine, was developed as a surgical anesthetic. It was first used on psychiatric patients because of its powerful calming effect; at the time it was regarded as a reversible "pharmacological lobotomy[3] The discovery of chlorpromazine's psychoactive effects in 1952 led to further research that resulted in the development of antidepressants, anxiolytics.

FUTURE RESEARCH- Coping with Antipsychotic Side Effects

Side effects may be reduced by decreasing the dose or by changing drugs, but this should always take place under medical supervision. Treatment may include beta-blockers such as propranolol or metoprolol, or benzodiazepines such as clonazepam. The FDA requires all manufacturers of atypical antipsychotics to include a warning about the risks of diabetes and hyperglycemia. Periodic monitoring of glucose should be considered for all patients on atypical antipsychotics.

USE Vs ABUSE
Common conditions with which antipsychotics might be used include schizophrenia, bipolar disorder and delusional disorder. Antipsychotics might also be used to counter psychosis associated with a wide range of other diagnoses, such as psychotic depression.[4] In addition, "antipsychotics" are increasingly used to treat non-psychotic disorders. For example, they are sometimes used off-label to manage aspects of Tourette syndrome or autism spectrum disorders.[5] Recently, risperidone was approved by the US FDA for the treatment of irritability in children and adolescents with autism.

nicotiana plant

kava plant roots

MECHANISM OF ACTION
It is believed, however, that the initial cause of psychotic behavior may originate from an imbalance of dopaminergic functions in the CNS. All antipsychotic drugs tend to block D2 receptors in the dopamine pathways of the brain. It is the blockage of dopamine receptors in this pathway that is thought to control psychotic experiences. Typical antipsychotics are not particularly selective and also block dopamine receptors in the mesocortical pathway, tuberoinfundibular pathway, and the nigrostriatal pathway. Atypical antipsychotic drugs have a similar blocking effect on D2 receptors. Antipsychotic drugs have a significantly stronger effect on the central nervous system (CNS), but they are not CNS depressants, and as a rule they are more toxic. However, even in long-term use they do not cause dependence and addiction like anxiolytics do.

REFERENCES
[1]Horacek J, Bubenikova-Valesova V, Kopecek M, et al. (2006). "Mechanism of action of atypical antipsychotic drugs and the neurobiology of schizophrenia". CNS Drugs 20 (5): 389 409. doi:10.2165/00023210-200620050-00004. PMID 16696579 [2] McEvoy J; Lieberman, JA; Stroup, TS; Davis, SM; Meltzer, HY; Rosenheck, RA; Swartz, MS; Perkins, DO et al (2006). "Effectiveness of clozapine versus olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia that did not respond to prior atypical antipsychotic treatment". Am J Psychiatry 163 (4): 60010. doi:10.1176/appi.ajp.163.4.600. PMID 16585434. [3]^ Choosing the right neuroleptic for a Patient (2008) [4]^ Docs.Google.com [5] ^ Antipsychotics in the treatment of autism (2008) [6] ^ Bellack AS (July 2006). "Scientific and Consumer Models of Recovery in Schizophrenia:
Concordance, Contrasts, and Implications". Schizophrenia Bulletin 32 (3): 43242. doi:10.1093/schbul/sbj044. PMC 2632241. PMID 16461575. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2632241

Valerian herb

Tranquilizers, also known as CNS depressants, can be highly addictive. Some who abuse tranquilizers mix them with other drugs, especially stimulants. These stimulants may be legal drugs that are being improperly used or illegal drugs, such as heroin or cocaine. Street names for tranquilizers include bennies, moggies, benzos, and tranks.

nicotine

olanzaine

RESEARCH POSTER PRESENTATION DESIGN 2011

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