Mellaril (Thioridazine Hydrochloride)

Mellaril Review

This medication is used for the treatment of certain mental conditions (e.g., schizophrenia, the manic stage of bipolar disorder).

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Mellaril Drug Class and Mechanism

Quetiapine is an oral antipsychotic drug used for treating schizophrenia and bipolar disorder. Although the mechanism of action of quetiapine is unknown, like other anti-psychotics, it inhibits communication between nerves of the brain. It does this by blocking receptors on the nerves for several neurotransmitters, the chemicals that nerves use to communicate with each other. It is thought that its beneficial effect is due to blocking of the dopamine type 2 (D2) and serotonin type 2 (5-HT2) receptors. T

Mellaril Uses

Thioridazine is a piperidine antipsychotic drug belonging to the phenothiazine drug group and was previously widely used in the treatment of schizophrenia and psychosis. It is available from various companies under the names Mellaril, Novorizadine, and Thioril. Due to concerns about cardiotoxicity and retinopathy at high doses this drug is prescribed less than it previously was. A serious side effect is the potentially fatal neuroleptic malignant syndrome. It exerts its actions through a central adrenergic-blocking, a dopamine-blocking and minor anticholinergic blocking activity.

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Mellaril Side Effects

For further information see: Phenothiazine The most commonly complained about side effect is the agonizing akathisia which is the main reason for low patient compliance Tardive dyskinesia characterized by involuntary movements of the lips, mouth, and tongue can be long lasting or irreversible. Neuroleptic malignant syndrome is potentially fatal. Central nervous system side-effects occur. These are mainly drowsiness, dizziness, fatigue, and vertigo. Early and late extrapyramidal side-effects are seen only infrequently (less than 1% altogether). There is no clear dose-effect relationship, as with higher doses anticholinergic effects of thioridazine become more prominent. Thioridazine causes also an unusual high incidence of impotence and anorgasmia due to a strong alpha-blocking activity. Painful ejaculation or no ejaculation at all is also sometimes seen. Autonomous side-effects (dry mouth, urination-difficulties, obstipation, induction of glaucoma, postural hypotension, and sinus tachycardia) occur obviously less often than with most other mildly potent antipsychotics. Thioridazine is no longer recommended as first-line treatment due its side-effect of prolonging the QT interval on the EKG. Thioridazine-5-sulfoxide is responsible for the ventricular tachycardia, torsades de pointes according to Heath, Svensson and Martensson.[6] Also, the serious and sometimes fatal blood damage agranulocytosis is seen more frequently (approximately 1/500 to 1/1,000 patients) with thioridazine than with other typical phenothiazines (1/2,000 to 1/10,000 patients). Thioridazine if given over a prolonged time and in high doses can be stored in the ocula and the retina of the eyes and in the heart muscle. Clinical consequences (disturbed or blurred vision) are rare.

Mellaril Pregnancy

There are no adequate studies of quetiapine in pregnant women . Studies in animals are inconsistent. Some studies suggest effects on the fetus and others show no effects. Quetiapine should only be used in pregnancy if the physician feels that it is absolutely necessary and that the potential benefits justify the unknown risks.

Mellaril Overdose

Many of the symptoms observed are extensions of the side effects described under ADVERSE REACTIONS. Mellaril® (thioridazine HCl) can be toxic in overdose, with cardiac toxicity being of particular concern. Frequent ECG and vital sign monitoring of overdosed patients is recommended. Observation for several days may be required because of the risk of delayed effects. Signs and Symptoms Effects and clinical complications of acute overdose involving phenothiazines may include: Cardiovascular: Cardiac arrhythmias, hypotension, shock, ECG changes, increased QT and PR intervals, non-specific ST and T wave changes, bradycardia, sinus tachycardia, atrioventricular block, ventricular tachycardia, ventricular fibrillation, Torsade de pointes, myocardial depression. Central Nervous System: Sedation, extrapyramidal effects, confusion, agitation, hypothermia, hyperthermia, restlessness, seizures, areflexia, coma. Autonomic Nervous System: Mydriasis, miosis, dry skin, dry mouth, nasal congestion, urinary retention, blurred vision. Respiratory: Respiratory depression, apnea, pulmonary edema. Gastrointestinal: Hypomotility, constipation, ileus. Renal: Oliguria, uremia. Toxic dose and blood concentration ranges for the phenothiazines have not been firmly established. It has been suggested that the toxic blood concentration range for thioridazine begins at 1.0 mg/dL, and 2-8 mg/dL is the lethal concentration range.

Mellaril More Information

Patients should be informed that Mellaril has been associated with potentially fatal heart rhythm disturbances. The risk of such events may be increased when certain drugs are given together with Mellaril. Therefore, patients should inform the prescriber that they are receiving Mellaril treatment before taking any new medication.