Active Ingredients

Bromperidol – Effect, Application & Risks

Bromperidol

Bromperidol is one of the active ingredients contained in classic neuroleptics . The highly potent substance has a strong antipsychotic effect. It is one of the successor substances to haloperidol , which was widely used in psychiatric clinics under the Haldol® label from the mid-1960s.

What is bromperidol?

Bromperidol has the molecular formula C21H23BrFNO2 and is an active substance that effectively combats the positive symptoms of schizophrenia in particular ( hallucinations , delusional thoughts, etc.).

It was marketed under the brand names Bromidol® and Bromodol® after its development by Janssen Pharmaceutica in 1966. Today, for example, it is also contained in the medicines Impromen® and Tesoprel®.

Bromperidol belongs to the class of butyrophenones , used exclusively to treat schizophrenia. The members of this group of active ingredients all have a 1-phenyl-1-butenone building block. Since bromperidol is one of the first antipsychotics to be synthesized at the time, it is considered a classic or typical neuroleptic. Because of its strong anti-psychotic properties, it is a highly potent drug, because even a low dose of bromperidol achieves a high effect.

However, as a potent antipsychotic, it is only mildly sedating. It can not regulate inner restlessness , sleep disorders , anxiety and states of agitation that occur during a psychotic episode. Therefore, in acute psychoses , bromperidol is usually administered together with a low-potency neuroleptic.

Pharmacological action

According to conventional wisdom, the positive symptoms of schizophrenic psychoses are caused by an excessive concentration of the neurotransmitter dopamine in the mesolimbic part of the brain . Like the other representatives of its active substance group, bromperidol is able to block the release of the messenger substance by acting as a D2 receptor antagonist. Misjudgments of reality, misperceptions and psychomotor agitation subside.However, if a neuroleptic with a strong sedating effect is not administered at the same time, the negative symptoms may intensify.

Even with bromperidol, schizophrenia can only be treated symptomatically. However, the patient comes to rest and is able to perceive his condition as pathological.

Medical Application & Use

Before treatment with bromperidol, a blood count is taken , which is supplemented by a differential blood count. The dosage of the drug is carried out individually. The average dose is 5 to 20 mg bromperidol daily. The maximum dose is set at 50 mg. As with other neuroleptics, a higher dose is administered for acute therapy than for long-term and recurrence prophylaxis.

In long-term therapy, the patient gets the drug with their meal. The effect occurs quickly after the first administration: Symptoms such as acoustic and visual hallucinations as well as paranoid ideas usually subside soon.

Bromperidol has an anti-psychotic effect 50 times more potent than chlorpromazine . Chlorpromazine was the first neuroleptic drug at the time and is used as a reference value when comparing the effectiveness of classic neuroleptics. In contrast to low-potency anti-schizophrenic drugs, bromperidol does not make you tired and also does not cause a drop in blood pressure , which reduces the risk of circulatory collapse .

Risks & side effects

As a highly potent anti-psychotic agent, bromperidol also has many side effects , the worst of which is extrapyramidal syndrome (EPS). The patient then develops symptoms similar to Parkinson’s with muscle stiffness ( rigor ), restlessness when sitting , trembling (tremor) etc. Therefore, people with schizophrenia with this secondary disease are also given anticholinergics .Depending on the dose and duration of therapy, treatment with bromperidol causes a structural change in the substance of the brain. In animal experiments, brain volume and weight (neurodegeneration) were reduced by around 10%.

The most common side effects that can occur when taking bromperidol are a lack of white blood cells ( leukopenia ), reduction in blood cell count ( anaemia ), hair loss , early and late dyskinesia, extrapyramidal syndrome, shortness of breath , pneumonia , thromboembolism , Parkinson’s symptoms , involuntary movements such as staring, swallowing and tongue spasms, and extreme restlessness. Occasionally, hypotension , accelerated heart rate , and peripheral edema may occur. In rare cases, diarrhea ,Nausea , vomiting , loss of appetite , vegetative symptoms , allergic reactions , drowsiness , cerebral convulsions, speech and memory disorders , sleep problems , neuroleptic malignant syndrome and depressive moods have been observed.

Bromperidol should not be used in patients with a comatose state, paragroup allergy, children under the age of 12 and people with cardiac , renal or hepatic insufficiency , prostate enlargement with residual urine formation, acute urinary retention , severe hypotension, Parkinson ‘s disease, endogenous depression, have organic brain diseases, severe epilepsy , hyperthyroidism , a known allergy to the active substance, glaucoma , heart attack and acute drug or alcohol dependence .

In animal experiments, damage to fertility could be proven. Although there is no evidence of similar effects in humans, the active ingredient should be used with extreme caution in pregnant women . Children born to mothers who received bromperidol during lactation later showed extrapyramidal symptoms. In patients with heart damage and the elderly, there could be a disturbance in the conduction of the heart.

Since bromperidol, like other neuroleptics, promotes the release of prolactin , which is regarded as the triggering substance in some types of cancer , such as breast cancer , it should also only be used in patients with breast cancer if there is an urgent need. The same applies to people with pathological blood values.

In all these cases, regular medical monitoring of the patient must be guaranteed. Since the active ingredient lowers the seizure threshold in epileptics, for example, it may only be administered to them if they are also receiving anticonvulsants . Alcohol and tranquilizers increase the effects of bromperidol, but tea, coffee and other caffeinated beverages reduce its effects.

 

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.