Causes and signs of azaleptin overdose, consequences of poisoning. Azaleptin poisoning Azaleptin lethal dose how many tablets

Most people who have never faced the problem of alcoholism do not understand its seriousness. But anyone who has gone through this knows how difficult and painful it is to see someone close to them destroying themselves with their own hands. Of course, family and friends always try to help the patient in such a situation, send him to the hospital, buy a magic pill that will immediately cure everything. Often such a pill becomes Azaleptin, a drug prescribed by narcologists for treatment. alcohol addiction. However, few people know that Azaleptin and alcohol should never be combined with each other. And if alcohol is not completely removed from the human body, then the use of this medicine can end very badly.

What is Azaleptin?

Progressive alcoholism is primarily a mental and psychological disease. A person’s ability to think critically is impaired and without alcohol they experience depressed mood, apathy, depression or psychosis. To help the patient cope with this, doctors prescribe azaleptin, a strong antipsychotic.

The main component of this drug is clozapine, which is very different from other antipsychotic drugs and composition, and, most importantly, in action. Doctors sometimes call it an atypical antipsychotic. It has significantly fewer side effects and is gentler. This is why, in addition to treating alcoholism, clozapine is prescribed for:

• Schizophrenia;
• Manic-depressive disorders (in the stage of excitement);
• Behavioral disorders;
• Insomnia;
• Nervous exhaustion;
• Psychomotor disorders;
• Some depressive disorders;
• and etc.

How does the drug affect the human body?

Once in the body, azaleptin blocks the work of some neurotransmitters. In other words, it depresses work nervous system and the person begins to treat everything that happens not so calmly, but rather indifferently. This helps to survive acute periods of psychosis.
But characteristic feature of this antipsychotic is the fact that it cannot be combined with other medicines. If you open the instructions for this drug, you will see that the point about interactions with other medications takes up a third of all the information, which is quite a lot. It also says in a separate line that the drug should not be used with alcohol or products containing ethanol.

What happens if you combine Azaleptin and alcohol?

In order to answer that question, you need to understand how ethanol acts on the nervous system.
At first, when it first enters the bloodstream, it causes a stimulating effect. It is worth noting that the dose of alcohol to achieve this effect is extremely small and individual for each person. Once it is exceeded, the opposite effect occurs - ethanol becomes a nervous depressant.

That is, at first the nervous system is greatly excited, but in order not to “burn out” and keep it intact, the body sharply slows down the process, and the cells’ ability to perceive anything drops sharply. Immediately after this, brain activity decreases, all muscles relax, and drowsiness begins to be felt.

Now remember that clozapine also depresses the nervous system. In essence, its action is similar to ethanol. At the same time, the metabolism of both substances occurs in the liver. It is very unlikely that liver enzymes will be able to cope with the processing of both substances at once, which means that one of them will be relegated to the background. As soon as this happens, the products of his metabolism will turn off the brain and the person, at best, will fall into a deep delirious state, from which he will not soon emerge. And after waking up, for a long time he will feel inhibited reactions, experience cramps, sleep poorly and experience breathing problems.

But this is only the most favorable option. It is quite possible that due to the inability of the liver to process ethanol, severe intoxication of the body will occur, which will lead to death. But even if this does not happen, then, upon waking up from severe delirium, the patient will be informed that he has serious liver dysfunction and that he will now remain disabled for the rest of his life.

Azaleptin and treatment of alcoholism

Azaleptin has been successfully used in psychiatry for many years. It very quickly causes a sedative, calming effect. And despite all the advantages, it has one big drawback, which has already been mentioned - it is not compatible with other drugs. Most often, mixing leads to a weakening of the effect of both drugs. Therefore, azaleptin is used only in monotherapy.

Sometimes this surprises patients - is it really possible that only one drug will be needed to treat such a serious disease as alcoholism? Not really. But while the patient is undergoing treatment with this particular antipsychotic, he cannot take anything else.

Therefore, it is best if such treatment takes place in a clinic, under the supervision of doctors and nurses. Moreover, in this case, the patient will definitely not miss taking the drug, and the likelihood of an overdose will be reduced to zero.

Usually the course of treatment lasts 2 weeks and if it takes place at home, the doctor is obliged to describe the dosage and the exact time of taking the drug. Despite the fact that azaleptin itself is not addictive, after it other conventional antipsychotics and antidepressants have no effect on a person.

Overwhelming majority medicines has poor compatibility with alcoholic beverages. These drugs include all antibiotics, a number of synthetic hormones, and anti-inflammatory medications. Many sedatives, including Azaleptin, should not be taken in parallel with alcohol.

This medicine is often prescribed in the treatment of alcohol dependence to eliminate symptoms of anxiety and restlessness, however, the parallel use of tablets with alcohol can significantly undermine health. This means that you initially need to stop drinking alcohol.

Features of the drug

Azaleptin is a drug that can be classified as a neuroleptic with a sedative effect. It is prescribed for a variety of mental disorders, including at the stage of treatment of alcohol dependence. It is available in the form of tablets for oral administration.

The composition includes the active substance - clozapine, which is a powerful antipsychotic. Thanks to this component, the product is effective. Doctors often prescribe Azaleptin tablets. One of obvious advantages The drug is considered to have a complex action. The drug solves at least three problems:

1. Sedative effect. The main task is to normalize the functioning of the nervous system. Thanks to the medication, the patient calms down. In a short time, signs of anxiety and severe causeless concern disappear. This helps prevent serious mental pathologies.
2. Soporific effect. With severe anxiety or a panic attack, a person becomes emotionally exhausted. He quickly loses strength and energy, and it takes time to restore them. Azaleptin helps to fall asleep, which makes the task of specialists easier: they do not need to administer additional sedatives to the patient.
3. Strengthening the effect of painkillers. Sometimes a person needs to take a sedative and an analgesic at the same time. Azaleptin is good because it increases the effectiveness of the latter. This means that with this combination of drugs it is possible to relieve pain quickly and for a long time.

Azaleptin – effective tablets, allowing to normalize the patient’s mental state in a short time. The duration of use is determined directly by the reason for the prescription.

When treating alcohol addiction, the medication is prescribed for 1.5-2 months, but the first improvements become noticeable much earlier. Restlessness and anxiety go away after 5 days of use. After 2-3 weeks, the person becomes less aggressive, he can already control his own emotions and suppress attacks of anger.

Use in the treatment of addiction to alcohol

Azaleptin is prescribed in different situations. It becomes an indispensable assistant in the treatment of alcohol addiction. Patients undergoing rehabilitation need sedatives, since withdrawal syndrome inevitably provokes mental disorders. On early stages Mild anxiety is quite likely, which gradually increases in intensity.

Treatment of alcohol addiction is a long process that is fraught with difficulties. The first 3-4 weeks of sobriety are considered especially difficult. This time is characterized by the development of numerous unpleasant symptoms. The very next day after giving up alcohol, a person develops:

• nausea and vomiting;
• diarrhea;
• headache;
• heart rhythm disturbance;
• tremor of the limbs;
• chills;
• pallor of the skin.

These symptoms are similar to a severe hangover. They are associated not only with the accumulation of acetaldehyde, but also with global changes in the body. All systems learn to function without ethanol. Initially, this is difficult, which is why a person suffers from so-called withdrawal.

Unpleasant symptoms have a direct effect on the nervous system. The psyche is also affected. It is often difficult to endure pain and discomfort; it is much easier to return to a bad habit again, but this will mean that all previous efforts were in vain.

Symptoms of alcohol withdrawal can provoke more than just mild irritability. Gradually it develops into real aggression, which is difficult to control. In this case, sedatives such as Azaleptin come to the rescue.

The pills are designed to relieve anxiety, reduce anger and aggression towards yourself or other people. This means that symptoms eliminated in time will not transform into more severe conditions.

Doctors confirm that patients taking Azaleptin reduce the risk of developing depression during treatment of alcohol dependence.

Additional Applications

Treatment of alcoholism is not the only area of ​​application of Azaleptin and its analogues. This sedative is also appropriate for other mental disorders associated with increased anxiety and irritability. So, the list of indications for use includes:

In all cases, the drug is prescribed by a doctor who observes the patient. Dosages and duration of therapy are selected individually, but for serious mental disorders, lifelong use of Azaleptin is often required. This measure allows you to correct the patient’s condition and prevent breakdowns.

Can I drink alcohol with Azaleptin?

The use of medication to alleviate withdrawal symptoms raises many questions among patients. Many of them concern the possibility of combining Azaleptin with alcohol. Doctors are convinced that to maintain health, you will have to stop drinking alcohol during treatment. This is an important condition for successful therapy.

It has been proven that the active substance of the drug, clozapine, does not combine well with ethyl alcohol. If both of these compounds are simultaneously present in the human bloodstream, then unpleasant consequences cannot be avoided. At the same time, vital organ systems will react.

This means that ignoring the instructions and recommendations of the doctor can be fraught not only with deterioration in health, but also with death. The severity of the consequences depends on several parameters, including the initial state internal organs, dose of the drug, volume of alcohol consumed.

Dangerous consequences for the body

A narcologist who selects medications for treatment of alcohol addiction will explain that medications are poorly compatible with alcoholic beverages.

The decision to quit drinking must be firm and unshakable. The very first breakdown can end in disaster if the patient takes antipsychotics with a sedative effect, such as Azaleptin.

According to doctors, combining the drug with alcohol is especially dangerous for the heart and liver. In addition, alcohol can increase side effects from taking pills.

Effect on the liver

This is a large digestive gland that produces bile, which is required for the complete processing of nutrients supplied with food. The functions of the organ do not end there. It is he who participates in the processes of removing waste drugs from the body.

Azaleptin, like all medications, is metabolized by liver cells. This means that during treatment with such an antipsychotic, the load on the gland will be increased. Organ tissues are capable of self-regeneration, but these processes proceed extremely slowly. It is best to worry about the health of the liver in advance and take all measures aimed at maintaining its health.

If a patient is undergoing treatment for alcohol addiction, it is likely that their liver is already quite damaged. Ethyl alcohol destroys gland cells, which leads to the development of inflammatory processes in it. The organ loses some of its functions and gradually dies.

The liver plays a critical role in neutralizing incoming alcohol. It is she who synthesizes the enzymes that catalyze chemical reactions oxidation of ethanol to acetaldehyde and acetic acid. With alcoholism, these processes occur constantly, therefore, the gland does not have time to recover after intense work. Additional intake of any medications, including Azaleptin, will provoke even greater damage, which is often irreversible.

Increased side effects

Azaleptin is an antipsychotic that can only be taken under the strict supervision of a physician. These measures are related to the fact that the medicine is not always well tolerated by patients. It has a number of side effects, which are described in detail in the instructions for the product. Doctors are convinced that all negative consequences can be intensified if even a small amount of alcohol enters the human body.

The most common side effects from treatment with Azaleptin are dizziness, headaches, confusion and occasional fainting. The listed symptoms occur even with a sober lifestyle, but when drinking alcohol the situation worsens.

Additional side effects may also occur, including:

• nausea;
• vomit;
• heartburn;
• weight gain;
• temperature increase;
• arrhythmia;
• convulsions;
• general weakness;
• insomnia;
• increased sweating.

Side effects from Azaleptin make you feel worse and often require medical care. If a person suffers from withdrawal symptoms, then it is almost impossible to avoid them.

Load on the heart and nervous system

The heart is a muscular organ that pumps blood throughout the body every minute, ensuring gas exchange in organs and tissues. Its work depends on many external and internal factors. Thus, taking antipsychotics does not always go without leaving a trace. The heart wears out with regular use of sedatives.

A similar situation occurs when drinking alcohol. Muscle tissue in alcoholics gradually degenerates into fat. This means that the heart cannot perform the usual amount of work. As a result, the risk of pathologies increases, including myocardial failure or myocardial infarction.

Azaleptin is designed to eliminate excessive anxiety and eliminate attacks of aggression. In alcoholics, the nervous system is often in an excited state. This provokes atypical reactions - anger, irritability.

Neuroleptics calm the psyche, but concurrent use of alcohol reduces their effectiveness to a minimum. In addition, sudden changes are fraught with even greater problems - prolonged depression, stress.

Additional instructions for treatment with Azaleptin

Neuroleptics are almost always prescribed in the treatment of alcohol dependence. They, like many other medications, cannot be combined with alcohol, so the patient should abstain from dangerous liquids. If the ban is violated, the effect of therapy almost completely disappears, and the health condition worsens.

Doctors note that Azaleptin does not combine well with other drugs, so it is best to take several consecutive courses rather than take pills with different effects at the same time. So, after treatment with antipsychotics, you can move on to restoring the liver or heart with the help of specialized medications.

Many note that it is difficult to give up alcohol, especially if the addiction has already moved to the physical level. If difficulties arise, you need to seek help from a psychotherapist. The specialist will explain what to do for successful treatment. If all recommendations are followed, Azaleptin will not cause harm and will quickly stabilize the state of the nervous system.

Publication in print media: Forensic medicine and medical law: Current issues. Materials scientific-practical conference with international participation, dedicated to the memory of the Honored Scientist of the Russian Federation, Professor G.A. Pashinyan. – Moscow 2011

N.A. Kiryukhina, S.V. Shigeev

GBUZ "Bureau of Forensic Medicine of the Moscow Department of Health", Moscow

Department of Forensic Medicine, Faculty of Medicine, State Educational Institution of Higher Professional Education, Russian State Medical University named after. N.I. Pirogov, Moscow

IN last years There has been a significant increase in the number of acute poisonings with clozapine. This drug is widely used in the treatment of mental illnesses, and is also used for the purpose of intentional poisoning (suicidal or criminal). According to literature data, clozapine came out on top in the structure of criminal poisonings, accounting for 99.7% of all criminal poisonings in Moscow.

Due to the peculiarities of the clinical picture during intoxication (a person “falls asleep” and is not able to resist), the drug is a convenient means for committing illegal actions. A feature of criminal poisoning with clozapine is the presence of a second toxicant - ethyl alcohol.

Clozapine belongs to the group of atypical antipsychotics ( distinctive feature group - substances practically do not cause extrapyramidal disorders). Clozapine is the international nonproprietary name of the drug; In forensic medicine, the trade name Leponex was previously often used. Also known as azaleptin, alemoxan, iprox and clozaril. According to its chemical structure, it is a tricyclic compound, formula C18H19ClN4, has elements of similarity with tricyclic antidepressants and partially with benzodiazepine tranquilizers. In addition to the antipsychotic effect (due to the blockade of dopamine D2 receptors of the mesolimbic and mesocortical systems), the drug has a sedative, antiemetic and hypothermic effect; antiserotonergic, antihistamine, peripheral and central m-anticholinergic and alpha-adrenergic blocking properties.

Dosage forms of clozapine: tablets, solution for injection, powder, granules for the preparation of an oral suspension for children. Leponex® manufactured by Novartis (Switzerland) is available in the form of tablets of 25 and 100 mg. Single dose for adults – 50-200 mg, highest daily dose– 600 mg. The lethal dose of clozapine for adults is 3 g, but the literature describes non-fatal cases of poisoning when taking higher doses of the drug (up to 16 g). At present, there is no doubt that a true idea of ​​the severity of chemical injury is given only by the quantitative content of the toxicant in the blood of patients. It should be emphasized that clozapine is characterized by close therapeutic and toxic concentrations, while great importance have an individual body response to the intake of a substance, prior to taking the drug with therapeutic purpose. When toxicometry of clinical manifestations in cases of clozapine poisoning was established, the threshold concentration was 0.12 ± 0.06 μg/ml of clozapine in the blood; critical – 1.01±0.2 µg/ml; lethal – 3.5±1.5 µg/ml. .

The drug is well absorbed from the gastrointestinal tract. Bioavailability – 27-60%. The maximum concentration (Cmax) in the blood is determined after 2.5 hours (1-6 hours). Communication with plasma proteins – 95%. Unevenly distributed in biological media; penetrates the blood-brain barrier, but accumulates in the brain in much smaller quantities than in the liver, lungs, and kidneys. It is characterized by enterohepatic circulation.

The work of Sokolova O.I. (2007) provides a comparison of clozapine and clonidine (the latter was widely used in the 90s of the last century for criminal purposes). The peak concentration of clozapine in the blood is reached later than that of clonidine, therefore, the necessary effect of an overdose is observed later, but the effect of the drug lasts longer.

Given the widespread prevalence of combined poisonings, it is important to note some features of the interaction of clozapine with other drugs. It is known that simultaneous use its use with substances that increase the activity of enzymes of the cytochrome P-450 system (finlepsin, phenitrine, nicotine) and primarily with ethyl alcohol leads to a decrease in the concentration of clozapine in the blood.

Clinical picture poisoning is characterized by a syndrome of depression of the central nervous system of varying severity depending on the concentration of the substance in the blood. At threshold concentrations, only lethargy, drowsiness, and adynamia are noted, while at critical and fatal levels, a coma of varying depths, dysfunction of external respiration (often requiring mechanical ventilation) and hemodynamic instability with the development of low cardiac output syndrome are observed. The latter is caused by a decrease in venous return of blood and impaired contractility under conditions of hypoxemia, while cardiac performance is maintained due to high tachycardia. A comatose state may be preceded by a neuroleptic syndrome, which is characterized by confusion, visual hallucinations (usually monotonous, low-dynamic), psychomotor agitation, and hypersalivation.

The cause of death on the 1st-2nd day of poisoning is intoxication. Severe disturbances of homeostasis, the functions of the central and peripheral nervous system, and the development of endotoxicosis lead to death. Two main variants of thanatogenesis can be distinguished: paralysis of the respiratory center and acute cardiovascular failure. In the somatogenic phase of poisoning, on days 3-6, the main causes of death are pneumonia and pulmonary embolism.

When starting a forensic medical examination of a corpse with suspected acute clozapine poisoning, you should pay attention to the following details. Among cases of criminal poisoning with this drug, men of working age predominate. The corpses of the dead are “suddenly” discovered by passers-by on the street, in forest parks, entrances, subway platforms, in electric train cars, at train stations, and bus stops. The history and follow-up may contain data regarding previous long-term use of clozapine for therapeutic purposes. When examining the scene of the incident and the corpse at the place of its discovery, packaging for various medicines and the substances themselves are often found, among which clozapine is found. This fact does not prove poisoning by a particular substance, but may indicate its use shortly before death.

Pathological changes in internal organs are predominantly nonspecific in nature and are manifested by discirculatory disorders and dystrophic changes in parenchymal organs, as in case of poisoning with other drugs of neurotropic action, which was noted back in 1982 by M. A. Sapozhnikova and M. V. Barinova. Cerebral edema, focal hemorrhages in the gastric mucosa, pulmonary edema, focal intraalveolar hemorrhages, distelectasis, dystrophic changes in the kidneys and myocardium are noted.

There is information in the literature about the so-called clozapine-associated eosinophilic myocarditis. In the 90s of the last century, J. E. Meeker and K. Worm drew attention to this when studying the corpses of those who died from acute fatal poisoning with clozapine. S. J. Haas et al. note that myocarditis sometimes develops in relatively young patients soon after starting treatment with clozapine, and is often fatal.

Researchers pay attention to changes in the liver and pancreas observed in the majority of those killed by clozapine poisoning.

Thus, morphological criteria for acute fatal poisoning with clozapine are not very specific and should be considered in conjunction with the results of forensic chemical research.

In 2007, O. I. Sokolova conducted a comprehensive study, during which new and improved existing methods for the detection and quantitative determination of clozapine isolated from biological objects were developed, based on thin-layer (TLC), gas-liquid and high-performance liquid chromatography (HPLC) . It has been established that when using the TLC method, the most sensitive detectors are iodine vapor and iodine-containing detectors; the detection sensitivity is in the range of 0.1–2 μg. Optimal conditions for determining the substance by HPLC were selected during isocratic chromatography of the standard and the studied extracts under the following conditions: eluent - methanol: phosphate buffer with pH 3 (80:20), column temperature 35 °C, elution at a rate of 100 μl/min. It has been revealed that for the analysis of clozapine it is possible to use IR spectrophotometry in the presence of two conditions: a sufficiently high degree of purification of extracts from biological material and the substance content in the object is at least 50 mg% (500 μg/ml). In methods for isolating clozapine from biological material, it is recommended to use 25 g (ml) of the object. The necessary volume and completeness of a forensic chemical study to draw up a conclusion on the detection of clozapine have been determined.

Fartushny A.F. (1999) analyzed the concentrations of clozapine in the blood and internal organs. According to his research, the lethal concentration of clozapine in the blood is 1.3 mg% (13 μg/ml), in the liver - 2 mg% (20 μg/ml), in the kidneys - 2.5 mg% (25 μg/ml).

Some foreign sources indicate a postmortem increase in the level of clozapine in the blood compared to that before death. The authors associate this with postmortem redistribution, one of the reasons for which may be the diffusion of the substance from organs with high concentrations into the blood.

Considering the relative availability of clozapine, its wide range of applications, and the possibility of being used for illegal purposes, it should be kept in mind when examining corpses with signs characteristic of acute poisoning. However, the forensic expert in his practical activities must remember that the detection of a toxicant in the tissues is not always identical to death from poisoning with it and can only indicate the use of this substance shortly before death. Despite the significant improvement in material and technical equipment, forensic experts encounter certain difficulties when studying such cases, which dictates the need to study in more detail the problem of diagnosing acute fatal poisoning with clozapine from the standpoint of an integrated approach. The assumption of a postmortem increase in clozapine in the blood compared to intravital requires further analysis.

Used sources

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Azaleptin is an antipsychotic drug that differs markedly from traditional antipsychotics. The drug has a sedative effect. It is prescribed to patients with cognitive disorders - decreased perception of information, mental abilities, and memory. The medicine is also indicated for schizophrenia, depression, manic states, and psychomotor agitation. The drug is toxic, so poisoning with azaleptin is possible when taking high doses.

Causes of drug poisoning, risk groups

The drug is available in tablets for oral administration. To reduce the likelihood of toxic effects, you need to take the medicine after eating. The maximum permissible daily dose for adults is 600 mg. Azaleptin poisoning occurs when the prescribed dosage is exceeded. This can happen accidentally and deliberately for the purpose of suicide.

The drug is dangerous to health, and its use in large quantities creates a direct threat to life; it is not prescribed to patients with severe mental disorders, alcohol and drug addiction.

• aged people;
• patients with serious kidney and heart diseases;
• thin, emaciated patients;
• if there is a history of pathology of the hematopoietic system;
• cerebrovascular diseases - hypertension, atherosclerosis, diabetes, IHD ( ischemic disease hearts).

Symptoms of azaleptin poisoning

The drug has a toxic effect on all internal organs and systems. Therefore, the signs of poisoning are multifaceted and appear in varying degrees of intensity.

The effect of azaleptin on the central nervous system is characterized by the following symptoms:

• dizziness, pain in the head, temporal region;
• an increase in body temperature that is not eliminated by antipyretics;
• fainting or short-term loss of consciousness;
• excited state, inexplicable excitement;
• muscle rigidity – increased skeletal muscle tone;
• tremor – convulsive movements of fingers and hands;
• akathisia is a pathological condition requiring constant change of body position (internal motor restlessness);
• confused consciousness, inadequate reactions to external stimuli;
• impossibility of voluntary movements.

In case of an overdose of azaleptin, insomnia is observed, the quality of sleep is disturbed, and its duration is reduced. The depressive state of the victims worsens and epileptic-type muscle cramps appear.

Toxic damage to the nervous system is reflected in the general condition. Blood pressure loses stability, the skin becomes pale, marbled, and cold to the touch. Falls sharply physical activity, general fatigue increases. The victim is sweating profusely.

Due to the toxic effect on the kidneys, oliguria develops (a decrease in the daily amount of urine); in severe cases, anuria (lack of urine) occurs several hours after poisoning, which indicates kidney failure. In men, potency is impaired.

Damage to the digestive organs is manifested by the following symptoms:

• dry mouth;
• nausea;
• heartburn;
• hypersalivation - uncontrolled active salivation;
• single or repeated vomiting;
• pain in the epigastric region, abdomen.

Azaleptin poisoning directly affects the qualitative and quantitative composition of the blood. The number of granulocytes (a group of leukocytes responsible for human immunity) in the peripheral blood of the victim decreases. In severe cases of intoxication, agranulocytosis occurs (absence of granulocytes). The first symptoms of this condition are chills, fever, high body temperature, uncontrollable thirst, inflammation of the mucous membranes and gums.

Once in the blood, the drug affects the respiratory system. The person experiences shortness of breath, the frequency of respiratory acts increases, but the depth of inspiration is minimal. Therefore, breathing is frequent, shallow, and sometimes intermittent.

Azaleptin in large doses disrupts metabolic processes in the body, leading to functional disorders of internal organs. With chronic poisoning, patients experience weight gain.

The victims have myasthenia gravis, a neuromuscular pathology characterized by rapid fatigue of striated muscles.

The adaptation or adjustment of the sense organs to external factors of irritation is disrupted. From the cardiovascular system, blood pressure decreases slightly.

Signs of severe azaleptin poisoning:

• feeling dazed due to the effect of the medication on the hearing aid;
• severe attacks of epilepsy, accompanied by intense convulsive seizures;
• inexplicable feeling of anxiety, restlessness;
• partial, short-term memory loss;
• madness;
• delusions and hallucinations;
• heart rhythm disturbances;
• a sharp drop in blood pressure, collapse;
• decreased peristalsis and intestinal motility, up to atony.

First aid and treatment of overdose

If no more than an hour has passed since taking large doses of azaleptin, you should urgently rinse your stomach. To do this, artificial vomiting is induced at home.

Algorithm for effective gastric lavage:

1. Place the person on a chair or lay him on his side, wrap him in a towel, and place a basin or bucket under his feet.
2. Give 2-3 glasses of cool water to drink for 2-4 minutes
3. Wrap your fingers in a cotton napkin, ask the victim to open his mouth, and press on the root of the tongue.
4. Such actions will provoke a gag reflex, and the contents of the stomach will come out.

After washing, give any of the sorbents to drink - activated or white carbon, Polysorb, Smecta.

The victim is prescribed symptomatic treatment. For severe nausea, antacid drugs - Almagel, Phosphalugel, Rennie. To reduce abdominal pain - antispasmodics. To calm the nervous system and improve sleep quality - sedatives.

Poisoning with azaleptin requires monitoring of cardiovascular activity and the water-salt balance of the body. This is due to a strong toxic effect on the myocardium, which can lead to arrhythmia, as well as a negative effect on the kidneys, including kidney failure. Therefore, patients are advised to keep plenty of fluids and undergo a heart control test - ECG.

The patient must continue to be monitored for a week even if there are no signs of poisoning.

The lethal dose of azaleptin has not been precisely established. It depends on the physical condition of the person, the resistance of his body to unfavorable external factors. To avoid overdose and its consequences, you must strictly adhere to the dose prescribed by your doctor.

One tablet of the drug contains 25 or 100 mg clozapine . In addition, the drug contains excipients such as lactose monohydrate , calcium stearate And potato starch .

Release form

The drug is available in tablets.

pharmachologic effect

From the outside of cardio-vascular system may appear orthostatic hypotension . Fainting also occurs in the first weeks of use.

From the outside urinary system: or .

In rare cases it appears collapse which is accompanied by stopping or difficulty breathing, arterial hypertension , changes on the ECG, hypertensionI , increased activity liver enzymes , cholestasis , extrapyramidal symptoms. There are isolated reports of development skin reactions ,rigidity, akathisia , malignant neuroleptic syndrome , sudden of death with long-term use. In addition, weight gain is possible.

As the dose increases, the risk of side effects increases.

Instructions for use of Azaleptin

The tablets are taken orally after meals 2-3 times a day, they should be washed down with a small amount of liquid. If the patient is prescribed Azaleptin, the instructions for use provide for several dosages. A single dose for adults ranges from 50 to 200 mg, the initial daily dosage is about 200 mg, the average daily dosage is about 300 mg, the highest daily dosage is 600 mg. The exact dose is selected individually. It's better to start with small quantity the drug, gradually increasing its consumption by 25-50 mg per day until a therapeutic effect is achieved. The instructions for use of Azaleptin indicate that it will appear gradually.

It will come first hypnotic And sedative action, reduction psychomotor agitation , aggressiveness (on average 5 days), then you should wait antipsychopathic effects (after 1-2 weeks) and only then the drug will have an effect on the symptoms (after about 1-1.5 months). After this, you should move on to the maintenance course.

Azaleptin overdose

An overdose of Azaleptin is dangerous because poisoning can occur. Its symptoms are stunned , increased , collapse , difficulty breathing, hypotension . In case of overdose, it is recommended to use sorbents , maintaining the functions of the respiratory and cardiac systems, as well as symptomatic treatment.

Interaction

Along with Azaleptin, it is contraindicated to use medications that can have a significant inhibitory effect on bone marrow function.

In addition, the drug may enhance the effect MAO inhibitors and drugs that suppress the functions of the central nervous system.

At the same time, it is necessary to prescribe with caution drugs that have anticholinergic And hypotensive effect , and also depress breathing.

If Azaleptin is used together with drugs that have an affinity for cytochrome P450 1A2 or cytochrome P450 2D6 , it is possible to increase the concentration of one of the drugs or both at once in the blood plasma. However, clinically significant interactions were still not observed when clozapine was combined with tricyclic antidepressants And antiarrhythmic drugs class C . However, an increase in their concentration in the blood plasma is theoretically possible, so it is recommended to use these drugs in a lower dose. The same applies to drugs that have a high degree of protein binding.

Agents that stimulate the functioning of system enzymes cytochrome P450 , may, in turn, reduce clozapine plasma concentrations.

The use of Azaleptin in combination with Cimetidine or at the same time may lead to increased plasma concentrations of clozapine, resulting in side effects.

In addition, Azaleptin weakens the effect of many dopamine stimulants . And its simultaneous use with drugs that affect the functioning of the nervous system can increase the likelihood of malignant neuroleptic syndrome .

When using gel-like antacids And absorption of Azaleptin from the intestine worsens. In addition, you must be careful when taking this drug together with antipsychotic , psychotropic , antiepileptic , hypoglycemic , sedative And antimicrobial agents , as well as derivatives sulfonylureas .

Azaleptin may reduce hypertensive effects norepinephrine and eliminate the pressor effect.

Terms of sale

This product is sold strictly according to prescription.

Storage conditions

The drug should be stored in a dry place, protected from light, out of reach of children. The optimal temperature is not higher than 30ºС.

Best before date

Azaleptin can be stored for 3 years if all conditions are met.

Analogs

Level 4 ATX code matches:

The main analogues of this product are: Azaleptol And Azapine . All of them are available in tablets with the active ingredient of 100 and 25 mg. In many cities, analogues are much more accessible than Azaleptin itself, so doctors often prescribe them.

Azaleptin and alcohol

Experts do not recommend using Azaleptin and alcohol together. The drug largely enhances the effect of alcoholic beverages on the central nervous system.