Benperidol is a drug from the group of butyrophenones. These belong to the neuroleptics. The drug is used to treat schizophrenia.
What is benperidol?
Benperidol is a drug from the group of butyrophenones. These belong to the group of neuroleptics. The drug is used to treat schizophrenia. Benperidol is a drug that is mainly used in psychiatry. It belongs to the group of butyrophenones. This group of drugs is used therapeutically as an antipsychotic. Other well-known butyrophenones are haloperidol or pipamperone. Benperidol, along with haloperidol and trifluperidol, is one of the most potent neuroleptics. While low-potency butyrophenones tend to have mild side effects, the high-potency butyrophenones such as benperidol have a high rate of side effects. The first butyrophenones were produced as early as the late 1950s. Benperidol and other butyrophenones have been used in psychiatric hospitals since the mid-1960s.
Pharmacologic action
Psychoses such as schizophrenia, depression, and mania are influenced primarily by neurotransmitter and hormone imbalances. Dopamine and serotonin in particular play an important role. The goal of drug treatment of psychosis is the inhibition of dopamine and / or serotonin receptors in the central nervous system (CNS). So-called dopamine and serotonin antagonists are used to inhibit the receptors. These compete with serotonin and dopamine for the receptor sites. One such dopamine antagonist is benperidol. It blocks the D2 dopamine receptors and thus has a drive-reducing effect. The drug also has sedative and antipsychotic effects. At a higher dosage of benperidol, the neurotransmitters histamine and adrenaline are also inhibited. These have an influence on the autonomic nervous system. Taking benperidol can therefore reduce movement disorders. To a small extent, benperidol also influences the neurotransmitter acetylcholine. This messenger plays a role in the transmission of nerve stimuli to muscle fibers. Because of this effect, benperidol may attenuate muscle twitching that can occur during a psychotic episode.
Medicinal use and application
Benperidol is used in the form of drops, ampoules, or tablets to treat psychosis. It may be administered orally or intravenously. Indications for benperidol administration include:
- Schizophrenia
- Delusions or obsessions during a psychotic episode
- Mood swings in mania
- Muscle twitching in catatonic syndrome
Risks and side effects
Due to its strong undesirable side effects, benperidol is now generally used only as a reserve agent in the treatment of schizophrenia. However, its use is steadily declining due to the advancement of neuroleptics. The effect of benperidol is very strong, so adverse effects occur with almost every treatment. One common adverse effect is extrapyramidal syndrome (EPS). In EPS, disturbances in movement occur. The movements increase or are decreased. They are associated with reduced or increased muscle tension. Affected patients suffer from sitting restlessness, tongue spasms, gaze spasms, tremors, and lack of movement. For prevention of EPS, benperidol is usually administered along with anticholinergics such as biperiden. Anticholinergics suppress the action of acetylcholine, preventing the transmission of nerve stimuli. Other common side effects of benperidol include hypotension, cardiac arrhythmias, lactation, menstrual irregularities, or sexual aversion. Occasionally, dizziness, depression, seizures, speech disorders, weight gain, increased blood sugar levels, or skin allergies occur. Very rare side effects include dry mouth, increased intraocular pressure, hair loss, and blood formation disorders. A dangerous complication that can develop when taking benperidol is malignant neuroleptic syndrome (MNS). This occurs much more frequently with benperidol than with other neuroleptics. MNS is thought to be caused by a dopamine deficiency due to a blockade of the D2 receptor.Typical symptoms of MNS include extreme muscle stiffness, tremors, increased reflexes, gaze spasms, lockjaw, profuse sweating, rapid heart rate, rapid breathing, fecal incontinence or urinary retention, confusion, mutism, impaired consciousness, and catatonia. The laboratory shows extreme elevation of creatine kinase and transaminases. The leukocyte count is elevated. There is excretion of myoglobin in the urine. Malignant neuroleptic syndrome is a feared complication because it develops very rapidly and unexpectedly and can be rapidly fatal. If MNS is suspected, benperidol must be discontinued immediately.
