Before talking about antipsycotic effect, i will describe what is Parkinson’s disease.
Parkinson’s disease (PD) is a complex neurobehavioral disorder. This disease that affects 7–10 million people worldwide and is more common in older people. The number of PD patients is expected to increase in parallel to the rising age of our population. PD is characterized by a progressive loss of motor function and a wide spectrum of nonmotor symptoms (NMSs). NMSs in PD have been systematically described and include a high prevalence of neuropsychiatric symptoms, such as psychosis, depression, cognitive impairment, and sleep disturbances.
in different word parkinsons symptoms is
unintentional, rhythmic muscle movement involving to-and-fro movements (oscillations) of parts of the body. It is can affect the hands, arms, head, face, voice, trunk, and legs.
- Slowed movement (bradykinesia)
Parkinson’s disease may slow down our movement. All task become time-consuming for parkinson ones.
- Rigid muscles
Muscle stiffness will be affect your body. The stiff muscles can be painful and limit your motion range.
- Impaired posture and balance
parkinsons symptoms maybe losing his balance. Structure will be change because feel painful in most part of bodies.
- Loss of automatic movements
There are a lot automatic movement in our body. Blinking is part of it. We can control it but it but most automatic ones. Beautiful smile after some interest things also automatic movement. Parkinson’s Disease people will difficult to do that. Swinging your arms when you walk is easy right. But for parkinson’s is opposite.
- Speech changes
Many people with this disease will difficult to speech normaly. Your speech may be more of a monotone rather than with the usual inflections.
- Writing changes
Tremor will affect capability of writing. Sign is impossible to do.
Parkinson’s Disease Causes
Neurons in the brain gradually break down or die in parkinson. Many of the symptoms are due to a loss of neurons that produce a chemical messenger in your brain called dopamine. When dopamine levels decrease, it causes abnormal brain activity. The cause of Parkinson’s disease is unknown, but several factors appear to play a role, including:
- Genes. Researchers have identified specific genetic mutations that can cause Parkinsons disease. But these are uncommon except in rare cases with many family members affected by Parkinsons Disease (PD).However, certain gene variations appear to increase the risk of Parkinson’s disease but with a relatively small risk of Parkinson’s disease for each of these genetic markers.
- Environmental triggers. Exposure to certain toxins or environmental factors may increase the risk of later Parkinsons, but the risk is relatively small.
Psychotic symptoms are present in up to 50% of patients with Parkinson’s disease. These symptoms have detrimental effects on patients’ and caregivers’ quality of life and may predict mortality. The pathogenesis of psychotic symptoms in Parkinson’s disease is complex, but the use of dopaminergic medications is one of the risk factors. The treatment of psychotic symptoms in Parkinson’s disease is complicated due to the ability of antipsychotic medications to worsen motor symptoms.
The use of antipsychotic drugs in patients with PD is complicated due to their ability to block dopaminergic D2 receptors which can induce dyskinesia and other extrapyramidal symptoms.
Antipsychotic drugs differ significantly in their affinity towards D2 receptors. It is generally accepted that Second Generation Antipsychotics (SGAs) are safer in patients with PD due to their lower D2 antagonism but they also can cause extrapyramidal symptoms, although in lower rates in comparison with First Generation Antipsychotics (FGAs).
With that we will descrebe what is different of First Generation Antipsychotics and Second Ones.
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First Generation Antipsychotics
D2 antagonists and are associated with higher risk of EPS
Second Generation Antipsychotics
5HT2A/D2 antagonists, are associated with lower risk of EPS and with higher risk of metabolic side effects.
What is the effective ones with First Generation Antipsychotics and Second Generation Antipsychotics become debate until now. But research found There is no evidence of benefit of second over first generation antipscyhotics in the treatment of negative symptoms of schizophrenia. The second result, Clozapine has shown clear utility in treatment-resistant schizophrenia.