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 well-known problem that generates a high level of suffering is schizophrenia. And fortunately for her, there are also drugs that help treat her symptoms. Among them is levomepromazine, which we will talk about next.

• Related article: "Types of psychoactive drugs: uses and side effects"

What is levomepromazine?

It receives the name of levomepromazine, a high potency psychoactive 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 as delusions, hallucinations and agitation.

Within the 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 it is characterized because it is highly effective in treat positive psychotic symptomatology (read the one that introduces elements into the psychic functioning of the subject, such as the aforementioned hallucinations or delusions) although they unfortunately produce bothersome secondary symptoms and even in some cases dangerous.

Besides, have no effect on and may even worsen negative symptoms, or that which is characterized by the deterioration or loss of functionalities previously present: impoverishment of language, apathy and affective flattening and impoverishment of thought or alogia.

Levomepromazine has 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, mainly metabolized in the liver, and excreted in the urine.

It can be found in different presentations including tablets and drops for oral administration or in the form of injections to be administered intravenously. One of the main trademarks 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 due to the fact that we are facing a dopamine antagonist, which blocks D2 receptors on neurons in the brain in such a way that neurons largely stop uptake of it 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 said excess is linked to the appearance of agitation, hallucinations and delusions.

However, the action of this drug and that of the other classic neuroleptics is non-specific, in such a way that the levels of dopamine in brain areas that do not have any excess of dopamine or that may even have a deficit (something that precisely occurs in the pathway mesolimbic when there are negative symptoms), in such a way that secondary symptoms such as motor or sexual symptoms may appear previously mentioned.

In addition to it also alters the levels of histamine, adrenaline and acetylcholine, something that can also cause harmful secondary symptoms.

• You may be interested in: "Dopamine: 7 essential functions of this neurotransmitter"

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 moderate to severe pain from different conditions.

In this sense, another of its most relevant indications is in palliative care, specifically in those patients who are in the terminal phase. Levomepromazine helps to treat agitation, delusions, and states of confusion and nervousness in these patients, especially when associated with pain.

It has even been used in some states of anxiety, depression, bipolar episode or obsessive disorder compulsive, although today there are a large number of drugs that are much safer and more useful for said conditions.

Side effects

Although it is effective in treating various conditions, the truth is that levomepromazine can generate effects side effects that are really annoying or even dangerous for the physical integrity of the person (although these are less frequent).

Among the most common we can find drowsiness or weight gain. Other less common side effects may include hyperglycemia and impaired glucose tolerance, the provocation of tardive dyskinesia or involuntary performance of repetitive movements, generally of the type masticatory. It can generate sexual dysfunctions such as erectile dysfunction or loss of libido, as well as hyperprolactinemia.

In some cases it also favors the growth of the breasts in men or the 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 may include possible pulmonary emboli, thrombosis, jaundice, agranulocytosis, or leukopenia (these two conditions involve the decrease in the levels of essential elements of the blood, respectively the granulocytes and the leukocytes).

It can cause liver damage, heart rhythm disturbances such as arrhythmias, bradycardia or tachycardia, enterocolitis (life-threatening) or the life-threatening neuroleptic malignant syndrome.

• You may be interested in: "Neuroleptic malignant syndrome: symptoms, causes and treatment"

contraindications

The adverse effects and the alteration that levomepromazine generates in the organism can become dangerous for some sectors of the population, which will have this drug contraindicated.

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 the drug if necessary.

It is contraindicated in patients with glaucoma, Parkinson's or porphyria. Its administration with other drugs should be avoided or discussed (especially if levodopa is consumed), and its consumption with alcohol is contraindicated.

They have it contraindicated or the condition of patients who have had cardiovascular, renal or hepatic alterations should be monitored (especially if renal or hepatic failure has been reached).

It is also not recommended in diabetic patients. (since it affects the blood glucose level) 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 have any type of dementia because it can increase the chance of premature death.