Neuroleptic or antipsychotic class of butyrophenones are also called neuroleptics or first generation. They are used in the treatment of schizophrenia, rather today in 2 nd intention, because of their tolerance. They can cause extrapyramidal disorders (found in Parkinson’s disease, abnormal movements, rigidity, involuntary muscle contractions) anticholinergic effects (dry mouth, tachycardia, diplopia, urinary retention, constipation), rhythm disturbances, a risk convulsive and hematological disorders.
Butyrophenones antiproductifs antipsychotic effects, especially hallucinations, effects antiemetisants and sedative effects (for pipamperone) and mixed (for haloperidol, a neuroleptic considered versatile).
These drugs are in the form of tablets, drinkable drops and injections.
Antipsychotic neuroleptic butyrophenone class, possess antidopaminergic which are charged, the antipsychotic effect desired therapeutic and side effects (extrapyramidal syndrome, dyskinesia, hyperprolactinemia).
Molecules with a sedative, also have antihistamine properties, the origin of these sedative effects generally sought in the clinic, and anticholinergic and adrenergic marked the origin of orthostatic hypotension.
The gastrointestinal absorption is complete after oral administration, but the bioavailability is 60%, due to first-pass metabolism of nearly 40%, fecal and urinary elimination half-life and is about 20 hours. The maximum plasma concentration after 2 to 6 hours, with a high interindividual variability.
All these pharmacokinetic parameters are that these molecules are administered orally, at rate of 1 to 2 doses per day.
Prescribing antipsychotic or neuroleptic butyrophenones aims to control symptoms and prevent complications and relapse of psychotic states, schizophrenia and behavioral disorders.
Butyrophenones antipsychotics are indicated in:
These are some complications that can occur when taking the drug, knowing that induced side effects vary among individuals.
In the use of antipsychotic butyrophenones have been reported:
Under treatment with antipsychotic butyrophenones must:
The use of antipsychotic butyrophenones is not recommended during pregnancy except for haloperidol. In the newborn haloperidol is sometimes responsible for extrapyramidal disorder, if continued late pregnancy (as hypertonia and tremor)
Due to the transition in breast milk, these molecules are not recommended during lactation.
Because of the risk of drowsiness, risk decreased alertness, blurred vision, dizziness associated with taking these drugs, patients’ attention should be drawn to drive and use machines.
The medication adherence is essential. Eliminating alcohol is important.
Butyrophenones associations with alcohol, antiemetisants, lithium, apomorphine, some neuroleptics (chlorpromazine, levomepromazine, sulpiride) to levodopa, are discouraged.
Associations with anticholinergic butyrophenones, antidiabetics, antihypertensives, carbamazepine, other neuroleptics, should be used with caution.
Butyrophenones associations with other depressant drugs central nervous system, are taken into account.