Teraligen® Valenta

The drug Teraligen belongs to the group of antipsychotics or neuroleptics. Sometimes its other name is teraligen valence. The most common form of the drug is tablets. They are recognizable by their dark pink film shell. The active substance in the medicine is alimemazine tartrate in an amount of 5 mg. Auxiliary ingredients used in production are listed in the instructions for use. You should familiarize yourself with the composition of the drug to exclude the occurrence of allergic reactions during treatment.

Pharmacodynamics and pharmacokinetics

Teraligen is an antipsychotic (antipsychotic) that has serotonin-blocking , antispasmodic and antihistamine effects, as well as hypnotic , antiemetic , antitussive and sedative effects.

You can observe the effect after taking it within 10-15 minutes, its duration of action is from 6 to 8 hours.

The drug has low antipsychotic activity , so it is ineffective in the acute stage of psychotic conditions .

It is also used for the treatment of elderly people, as well as children and adolescents, as the drug is well tolerated.

Absorbed completely, quickly, the maximum concentration in plasma can be observed after administration after 1-2 hours. Within 2 days it is excreted as a metabolite by the kidneys (70-80%).

Indications for use

This medicine is used to treat the following diseases:

• sleep disorders;
• senestopathic depression;
• in case of somatic diseases, a state of anxiety and excitement;
• psychopathy with psychoasthenic and asthenic disorders;
• somatized mental disorders;
• neuroses and neurosis-like conditions of organic or endogenous origin with hypochondriacal , psychovegetative , senestopathic and phobic disorders ;
• allergic reactions;
• anxiety-depressive diseases (with vascular and borderline diseases).

TERALIGEN VALENTA

Indications

As a sedative (calming), anxiolytic (anti-anxiety) and hypnotic:
- dementia (in

including dementia due to epilepsy), occurring with manifestations of psychomotor agitation, anxiety affect (as part of combination therapy);

— organic anxiety disorder

(as monotherapy or as part of combination therapy);

— schizophrenia

(with a predominance of neurosis-like disorders, as part of combination therapy);

— mood disorders

(affective disorders) - as part of combination therapy;

— generalized anxiety disorder

(as part of combination therapy);

— obsessive-compulsive disorder

(as part of combination therapy);

— reaction to severe stress and adaptation disorders (acute

stress reaction, post-traumatic stress disorder, unspecified reaction to severe stress, other reactions to severe stress) - as part of combination therapy;

— dissociative (conversion) disorders

(as part of combination therapy);

— somatoform disorders

(somatization disorder, undifferentiated, somatoform disorder, hypochondriacal disorder, somatoform dysfunction of the autonomic nervous system, persistent somatoform pain disorder, unspecified somatoform disorder, other somatoform disorders) - as part of combination therapy for severe anxiety or when standard therapy is ineffective;

— unspecified autonomic nervous system disorder, other autonomic nervous system disorders

(as part of combination therapy);

— anorexia nervosa

(as part of combination therapy);

— emotionally unstable personality disorder

(impulsive and borderline types) - as part of combination therapy;

- histrionic personality disorder, anxious (avoidant, avoidant) personality disorder

(as part of combination therapy);

— persistent personality changes after experiencing a disaster

(as part of combination therapy);

— hyperkinetic behavior disorder

(as part of combination therapy);

— family-confined conduct disorder

(as part of combination therapy when standard therapy is ineffective);

— unsocialized behavior disorder

(as monotherapy or as part of combination therapy);

— restlessness, agitation and other symptoms and signs related to emotional state

(as part of combination therapy);

— other neurotic disorders

(neurasthenia, unspecified neurotic disorder) - as part of combination therapy;

— insomnia of non-organic etiology

(as part of combination therapy when standard therapy is ineffective);

— emotional disorders whose onset is specific to childhood

(phobic anxiety disorder in childhood, social anxiety disorder in childhood, sibling rivalry disorder, unspecified emotional disorder in childhood, other emotional disorders in childhood) - as part of combination therapy.

As an antiallergic agent:

- itching regardless of location and etiology (anal itching, vulvar itching, unspecified anogenital itching, itching with photocontact dermatitis and solar urticaria, dermatitis, eczema, urticaria, bites or stings from non-venomous insects or other non-venomous arthropods, chickenpox, measles, Hodgkin's disease , diabetes mellitus, herpes zoster) as monotherapy or as part of combination therapy;

— asthma, hay fever, whooping cough

(as part of complex therapy as an antiallergic agent to relieve cough, shortness of breath and asthma attacks);

— unspecified allergy (in

as monotherapy or as part of combination therapy).

Contraindications

Teraligen has a number of contraindications:

• children under 7 years old;
• hypersensitivity to any ingredient of the drug;
• myasthenia gravis;
• pregnancy;
• prostatic hyperplasia;
• taking MAO inhibitors ;
• lactation;
• parkinsonism;
• angle-closure glaucoma;
• Reye's syndrome;
• kidney and liver diseases (severe stage).

The drug is prescribed with caution in the following cases: bone marrow suppression , epilepsy , arterial hypotension , chronic alcoholism, jaundice , predisposition to urinary retention, open-angle glaucoma , bladder neck obstruction .

Teraligen 5mg 50 pcs. pills

pharmachologic effect

Antipsychotic (neuroleptic).

Composition and release form Teraligen 5 mg 50 pcs. pills

Tablets - 1 tablet:

• active substance: alimemazine tartrate - 5.0 mg;
• excipients: lactose - 90.0 mg, colloidal silicon dioxide - 0.5 mg, refined sugar (sucrose) - 14.0 mg, wheat starch - 42.0 mg, tapioca (tapioca starch) - 2.0 mg, talc - 2.0 mg, magnesium stearate - 1.5 mg;
• shell: hypromellose - 4.0 mg, macrogol 6000 - 0.4 mg, titanium dioxide - 0.1 mg, Osprey R110 pink dye - 0.3 mg, talc -1.0 mg.

10 or 25 tablets per blister pack. 1, 2, 5 blister packs along with instructions for use are placed in a cardboard pack.

Description of the dosage form

Dark pink coated tablets with an embossed symbol on one side and a stripe on the other; sides and edges are undamaged.

Directions for use and doses

Inside. The daily dose is distributed into 3-4 doses.

Adults 5-10 mg/day (hypnotic effect); 60-80 mg/day (anxiolytic effect). For psychotic conditions - 0.2-0.4 g/day.

Children over 7 years of age are prescribed according to the following scheme (depending on age and body weight):

2.5 -5 mg/day (hypnotic effect)

5-20 mg/day (as a symptomatic treatment of allergic reactions)

20-40 mg/day (anxiolytic effect)

In psychotic conditions, the daily dose may be increased to 60 mg/day.

Pharmacodynamics

Antipsychotic (neuroleptic) has antihistamine, antispasmodic, serotonin-blocking and moderate alpha-blocking effects, as well as antiemetic, hypnotic, sedative and antitussive effects. The antipsychotic effect is due to the blockade of dopamine D2 receptors of the mesolimbic and mesocortical systems. The sedative effect is due to the blockade of adrenergic receptors in the reticular formation of the brain stem; antiemetic effect - blockade of B2 receptors in the trigger zone of the vomiting center; hypothermic effect - blockade of dopamine receptors of the hypothalamus. The onset of the effect is after 15-20 minutes, the duration of action is 6-8 hours.

It has low antipsychotic activity, therefore it is ineffective in acute psychotic conditions.

Due to its good tolerability, it is used in pediatric, adolescent and gerontological practice.

Pharmacokinetics

It is quickly and completely absorbed, the maximum plasma concentration is observed 1-2 hours after oral administration. Bonding with plasma proteins is 20-30%, half-life is 3.5-4 hours. Excreted by the kidneys - 70-80% in the form of a metabolite (sulfoxide) within 48 hours. The onset of the effect is after 15-20 minutes, the duration of action is 6-8 hours.

Indications for use Teraligen 5 mg 50 pcs. pills

Neuroses and neurosis-like conditions of endogenous and organic origin with a predominance of senestopathic, hypochondriacal, phobic and psychovegetative disorders; psychopathy with asthenic and psychoasthenic disorders; anxiety-depressive conditions within the framework of borderline endogenous and vascular diseases; senestopathic depression, somatized mental disorders; states of excitement and anxiety in somatic diseases; sleep disorders of various origins, allergic reactions (symptomatic treatment).

Contraindications

Hypersensitivity, angle-closure glaucoma, prostatic hyperplasia, severe liver and kidney diseases, parkinsonism, myasthenia gravis, Reye's syndrome, simultaneous use of MAO inhibitors, pregnancy, lactation; children's age up to 7 years.

With caution: hr. alcoholism, if there is a history of complications when using phenothiazine drugs; obstruction of the bladder neck, predisposition to urinary retention, epilepsy, open-angle glaucoma, jaundice, bone marrow suppression, arterial hypotension.

special instructions

With long-term treatment, it is necessary to systematically conduct a general blood test and evaluate liver function.

May mask the ototoxic effect (tinnitus and dizziness) of co-administered drugs. Increases the need for riboflavin.

To prevent distortion of the results of skin prick tests for allergens, it is necessary to cancel 72 hours before allergy testing.

During treatment, false positive pregnancy test results are possible.

During treatment you should not drink alcohol.

Impact on the ability to drive vehicles and operate machinery

During treatment, you should not engage in activities that require increased concentration.

Overdose

Increased adverse reactions, depression of consciousness. Treatment is symptomatic.

Side effects Teraligen 5 mg 50 pcs. pills

The drug is usually well tolerated. Side effects are extremely rare and mild.

From the nervous system: drowsiness, lethargy, fatigue, occurring mainly in the first days of use and rarely requiring discontinuation of the drug; paradoxical reaction (anxiety, agitation, “nightmare” dreams, irritability); rarely - confusion, extrapyramidal disorders (hypokinesia, akathisia, tremor); increased frequency of night apnea, increased seizure activity (in children).

From the senses: blurred visual perception (accommodation paresis), noise or ringing in the ears. From the cardiovascular system: dizziness, decreased blood pressure, tachycardia.

From the digestive system: dry mouth, atony of the gastrointestinal tract, constipation, loss of appetite.

From the respiratory system: dry nose, throat, increased viscosity of bronchial secretions.

From the urinary system: bladder atony, urinary retention.

Other: allergic reactions, inhibition of bone marrow hematopoiesis, increased sweating, muscle relaxation, photosensitivity.

Drug interactions

Enhances the effects of narcotic analgesics, hypnotics, anxiolytic (tranquilizers) and antipsychotic drugs (neuroleptics), as well as drugs for general anesthesia, m-anticholinergic drugs and antihypertensive drugs (dose adjustment required).

Weakens the effect of amphetamine derivatives, m-cholinergic stimulants, ephedrine, guanethidine, levodopa, dopamine.

Ethanol and drugs that suppress the action of the central nervous system - central nervous system depression.

Antiepileptic drugs and barbiturates reduce the threshold of convulsive activity (dose adjustment required).

Beta-blockers increase (mutually) plasma concentrations (a pronounced decrease in blood pressure and arrhythmias are possible).

Weakens the effect of bromocriptine and increases the concentration of prolactin in the blood serum. Tricyclic antidepressants and anticholinergic drugs enhance m-anticholinergic activity

MAO inhibitors (simultaneous administration is not recommended) and phenothiazine derivatives increase the risk of arterial hypotension and extrapyramidal disorders.

When alimemazine is co-administered with drugs that inhibit bone marrow hematopoiesis, the risk of myelosuppression increases.

Hepatotoxic drugs enhance the manifestations of hepatotoxicity of the drug.

Side effects

Teraligen tablets are well tolerated and rarely cause side effects.

The following side effects are possible:

• tachycardia , decreased blood pressure , dizziness ;
• accommodation paresis , ringing, tinnitus;
• increased viscosity of bronchial secretions, dry throat and nose;
• lethargy, drowsiness, fatigue (these symptoms usually occur in the first days and do not require discontinuation of the drug), nightmares, anxiety, irritability, agitation; in rare cases, hypokinesia , confusion, tremor , akathisia , and in children - increased convulsive activity;
• urinary retention, bladder atony ;
• loss of appetite, constipation , gastrointestinal atony, dry mouth;
• muscle relaxation , inhibition of hematopoiesis in the bone marrow, photosensitivity , allergic reactions, increased sweating.

Teraligen and alcohol

The combination of drugs and alcohol does not go away without leaving a trace; it can often lead to very serious consequences. You should be especially careful when taking psychotropic medications like Teraligen.

Teraligen should not be taken with alcohol!

The instructions attached to the medication clearly indicate that it is strictly forbidden to take it with alcohol, since it can only increase the severity and intensity of the underlying pathology.

The annotation for the drug indicates the side effects that occur when combining Teraligen + Alcohol:

• irritability and anxiety, nightmares and emotional overexcitement;
• drowsiness and excessive fatigue, lethargy;
• confusion;
• visual impairment, manifested by blurred perceived image;
• disorders such as tremor, an internal need to constantly move, or, conversely, a condition associated with insufficient movement activity;
• frequent cases of respiratory arrest during night sleep;
• extraneous sounds in the ears, frequent dizziness and fainting, decreased blood pressure;
• dryness of the mucous membranes in the mouth, nasal cavity, pharynx, lack of appetite, various allergic manifestations;
• tachycardia disorders, hyperhidrosis, disorders in bone marrow hematopoiesis;
• urinary retention;
• lack of normal tone in the muscular system of the gastrointestinal tract, bladder, as well as muscle relaxation, etc.

Remember that antipsychotic drugs have a strong effect on the central nervous system. Only a doctor can prescribe antipsychotics. In addition, a prescription is required to purchase such medications.

Instructions for use of Teraligen (Method and dosage)

The tablets are intended for oral administration.

To obtain a hypnotic effect, adults need to take 5-10 mg per day, an anxiolytic effect - 60-80 mg, and in a psychotic state - 0.2-0.4 g.

Instructions for Tiralijen for children (over 7 years old): to achieve a hypnotic effect - 2.5-5 mg, anxiolytic effect - 20-40 mg, for the treatment of allergic reactions - 5-20 mg. The daily dose for a psychotic state can be increased to 60 mg.

The daily dose should be divided into 3-4 doses.

Psychotropic drugs with multireceptor activity, in particular traditional minor neuroleptics, have firmly won their place not only in psychiatry, but also in many other areas of medicine. However, today there is a tendency to give preference to modern atypical psychotropic drugs due to their greater selectivity of action and better tolerability. But, as practice shows, not all “new” drugs can demonstrate high efficiency, and in turn, not all “old” drugs are characterized by a high severity of adverse effects and can successfully compete with modern drugs in terms of effectiveness. Teraligen (alimemazine) occupies a special place in the group of traditional minor antipsychotics. Alimemazine is one of the phenothiazine derivatives - 10-(3-dimethylamino-2-methylpropyl)-phenothiazine hydrotartrate - and is close in chemical structure to diprazine and levomepromazine. This drug was synthesized in France in the laboratory in 1958 and quickly found its use as a strong “neurostatic, antihistamine and vegetotropic drug” [17]. It is distributed under the trade names: Panectyl - in Canada, Repeltin - in Germany, Temaril - in the USA, Theralen - in France and Italy, Vallergan - in England, etc.

Currently, in Russia, alimemazine exists under the commercial name “Teraligen” and is produced.

The pharmacological properties of alimemazine were first studied by S. Courvoisier [17], I. Rosenblum [24] and A. Fernandez-Zoila [18]. In comparative studies, these authors found that alimemazine has a less pronounced adrenolytic effect than chlorpromazine and is inferior to it in the severity of its antiemetic and general depressive effects, but is superior to it in its effect on the general tone of the autonomic nervous system and in its antispasmodic effect on smooth muscles , as well as antihistamine and antiserotonin effects. Subsequently, many researchers turned to the study of alimemazine, finding new facets of the use of the drug. It was found that alimemazine combines neuroleptic and anxiolytic properties and has significantly less parkinsonian and hypotensive effects than other phenothiazine derivatives. According to the results of early [16, 21, 22, 23] and more modern studies [5, 6, 8] of the mechanism of action of alimemazine, it was found that it has antihistamine, antispasmodic, serotonin-blocking, moderate α-adrenergic blocking, as well as antiemetic, hypnotic, sedative and antitussive actions. The antipsychotic effect is due to the blockade of dopamine D2 receptors of the mesolimbic and mesocortical systems and is implemented in a dose of 200 mg/day, according to the instructions. The vegetative stabilizing effect is associated with the blockade of noradrenergic receptors. Sedative and hypotensive effects are caused by blockade of adrenergic receptors of the reticular formation of the brain stem; sleeping pills and antihistamines - with blockade of histamine receptors; anxiolytic effect - with blockade of serotonin and adrenergic receptors; the antispasmodic effect is associated with blocking cholinergic and noradrenergic receptors; antiemetic effect - with blockade of D2 receptors of the trigger zone of the vomiting center; hypothermic effect - with blockade of dopamine receptors of the hypothalamus. The effect of the drug begins 15–20 minutes after taking it, and the duration of action is 6–8 hours.

Due to its properties, alimemazine quickly found application in a variety of areas of clinical medicine. As a drug that has an antiallergic effect and affects the general tone of the autonomic nervous system [1, 3, 12], the drug began to be used in the practice of treating skin diseases (pruritic and allergic dermatoses) [13, 20] and internal diseases (for dyspneic disorders), otorhinolaryngology (Meniere's disease and Meniere-like attacks), various allergic diseases [5, 21]. In addition, alimemazine is used during the preparation of patients for such painful and complex procedures and studies as esophagoscopy, gastroscopy, etc. In gastroenterology, it is also used to relieve pain in peptic ulcers and chronic colitis [5, 8]. In gynecological practice, the drug is used for premenstrual syndrome, dysmenorrhea, chronic inflammatory processes in the pelvis, lumbodynia, etc. [23].

Being an antipsychotic, Teraligen (alimemazine) has found its widest use in psychiatry and neurology. According to A. Fernandez-Zoila [18], who studied the drug in outpatient practice, Teraligen has pronounced tranquilizing and hypnotic effects. In the treatment of psychotic disorders, it can soften the manifestations of states of psychomotor agitation, hallucinations and normalize sleep. According to various authors [4, 11, 14, 15, 16], Teraligen occupies one of the most important places among anxiolytics, and combination treatment in combination with antidepressants, depending on the characteristics of the structure of the psychopathological syndrome, significantly increases its therapeutic effect in the treatment of affective and neurotic disorders.

Today, in practical psychiatry, Teraligen is equally widely used in hospitals and in outpatient care, both as the main therapeutic drug and in combination with other psychotropic drugs, incl. and neuroleptics. Most often, Teraligen is prescribed for the treatment of borderline and neurotic disorders, in particular hypochondriacal and somatoform conditions with gastrointestinal dysfunction. Clinical example: patient T., 53 years old. Diagnosis: post-traumatic stress disorder, somatoform disorder (ICD-10 code F43.1, F45.32). Nurse, married, has an adult son. Throughout her life she was extremely responsible, efficient, and anxious. After the death of her mother 3 years ago, she grieved the loss, regretted that she might not have done what she could, and felt a sense of guilt. Night sleep was permanently disturbed. Later, about two years ago, she began to notice dyspeptic disorders, mainly in the form of diarrhea after any stressful situations for herself. Subsequently, I almost constantly felt discomfort in the intestinal area, rumbling in the stomach, frequent bowel movements, was fixated on my sensations, and could not fully work. I consulted a gastroenterologist and took treatment that did not bring much effect or the effect was short-lived. I felt disappointed, confused, and suspected an incurable disease. She visited a psychiatrist with complaints of anxiety and insomnia. According to the Hamilton HARS scale, the level of anxiety disorders corresponded to 28 points (high level of anxiety). A β-blocker, an antidepressant from the group of serotonin reuptake inhibitors and Teraligen were prescribed with a gradual increase in the daily dose to 20 mg per day. For the first 3–4 days, the patient experienced severe drowsiness and lethargy. Then she became somewhat more active. During the first five days, the patient's fixation on unpleasant bodily sensations decreased, the feeling of rumbling and bloating decreased, the urge to defecate began to decrease, and falling asleep improved. When assessed on the Hamilton HARS scale, a decrease in the level of anxiety was revealed to 19 points (average level, closer to high). Subsequently, after about 10–14 days, discomfort in the intestinal area decreased significantly and stool returned to normal.

In the treatment of this patient, Teraligen was used as an anti-anxiety, antidepressant, vegetostabilizing, antispasmodic and hypnotic agent. All this was achieved due to the multireceptor effect of the drug associated with the blockade of noradrenergic, histamine, serotonin receptors, as well as cholinergic and adrenergic receptors.

Teraligen is effective in the treatment of panic disorders, incl. with respiratory dysfunction. Clinical example: patient A. 28 years old. Diagnosis: panic disorder in a hysterical personality, adaptation disorder in the form of a mixed anxious and depressive reaction (F41.1, F60.4, F43.22). Middle manager, divorced, has an 8-year-old son. She complained of periodic panic attacks with palpitations, a feeling of suffocation, and fear of death. Such attacks usually occur in transport, closed, crowded spaces. The patient is forced to leave the place where the attack occurs and tries to avoid crowds of people. The attacks last from 40 minutes to an hour, then gradually pass after a change of environment. Subsequently, the patient experiences weakness, lethargy, and tearfulness. Previously, such episodes were noted several times in adolescence, but then spontaneously - without special treatment - stopped. The current deterioration of her condition arose against the background of the divorce process, which the patient perceives extremely painfully, considering herself to be the disadvantaged, offended party. Outside of attacks, the patient experiences a depressed mood with anxiety about the future, often cries, cannot fully engage with her child, lies a lot, demands the attention of relatives and friends, and experiences a constant feeling of lack of air. Night sleep is not disturbed. At the appointment she is capricious, demonstrative, demanding of the doctor, and talks about the real risk of “dying of fear.” During the conversation he sobs noisily, but afterwards he calms down and agrees with the proposed treatment. When assessing the state on the Hamilton HARS scale, a high level of anxiety was revealed, corresponding to 38 points. Prescribed: β-blockers, an antidepressant from the group of serotonin reuptake inhibitors, Teraligen with a gradual increase in dose to 30 mg per day. During the first week of treatment, general anxiety decreased somewhat, but drowsiness was noted during the day. Starting from the 8th–9th day of admission, the patient became more active, began to go outside, and her mood improved. When assessing the condition on the HARS scale, 19 points were noted (the average level is closer to high). After 14 days from the start of treatment, the patient was able to travel several stops on the subway. While on the road, I experienced tension associated with the expectation of a possible attack, but there was no pronounced panic with palpitations and a feeling of lack of air. Subsequently, during the month of taking the prescribed therapy, she regularly used transport and visited shops. She noted minor discomfort, which she dealt with. I was critical of my feelings. On the HARS scale, the level of anxiety disorders corresponded to 13 points (average level). In the treatment of this patient, Teraligen was also used as an anti-anxiety, antidepressant, vegetative stabilizing and antispasmodic agent. Accordingly, clinical effects were achieved through effects on noradrenergic, serotonin, cholinergic and adrenergic receptors.

Teraligen is effective in the treatment of somatoform autonomic dysfunction of the cardiovascular system. Clinical example: patient I., 63 years old, pensioner. Diagnosis: adaptation disorder in the form of a mixed anxiety and depressive reaction, somatoform disorder (F43.22, F45.30). The patient complained of increased nervousness and anxiety, usually associated with solving real pressing problems. Lately he has noticed a decrease in emotional stability even to minor problems. I began to notice similar phenomena after menopause. About 10 years ago, he was diagnosed with hypertension, is being seen by a therapist, and is receiving appropriate treatment. But in emotionally significant situations, he notes an increase in blood pressure, palpitations, increased heart rate, tremor of the fingers, and sometimes a feeling of coldness in the extremities. Periodically experiences difficulty falling asleep, usually associated with emotional stress. On the Hamilton scale, the level of anxiety corresponded to 23 points (medium level of anxiety, closer to high). Prescribed: an antidepressant from the group of serotonin and norepinephrine reuptake inhibitors, Teraligen at a dose of up to 15 mg daily. During the first 3 days of treatment, during the treatment, she noted some lethargy and a feeling of dullness in the morning. Then gradually over the next 4 days these phenomena were reduced. She became more active and noted greater resistance to emotional stress. Episodes of high blood pressure have become much less frequent. In special situations, the patient independently resorts to a one-time additional dose of Teraligen in the amount of 2.5 mg, notifying the doctor. The level of anxiety on the Hamilton scale corresponds to 10 points (medium level, closer to low). As in the two previous cases, Teraligen was prescribed to this patient for vegetostabilizing hypotensive purposes as an anti-anxiety drug and as a means of improving night sleep. The clinical effect was achieved due to the effect of the drug on noradrenergic, histamine, serotonin and adrenergic receptors.

Teraligen is effective in the treatment of asthenic disorders associated with tension and insomnia. Clinical example: patient P., 42 years old. Diagnosis: neurasthenia (F.48.0). I went to see a psychiatrist for the first time. All his life he was an active, active person. Successfully moved up the career ladder. Currently he is the head of a large enterprise, with more than 100 people subordinate to him. Married, has children. After an unfavorable period associated with work, against the background of increased physical and mental stress, in the last 2–3 months I began to notice rapid fatigue, a difficult feeling of internal tension to overcome, irritability directed mainly at loved ones, difficulty falling asleep and a lack of feeling of rest in the morning. On the Hamilton scale, the level of anxiety corresponded to 12 points (average level, closer to low). Was prescribed: nootropic therapy, Teraligen up to 7.5 mg per day. During the first 2–3 days, I began to notice an improvement in falling asleep, and after 5–7 days of use, irritability significantly decreased, self-control improved, and the feeling of internal tension disappeared. At this point, there was a reduction on the Hamilton scale and the level of anxiety corresponded to 6 (medium level, closer to low). In the treatment of this patient, Teraligen primarily served as a sedative and anxiolytic agent for the purpose of correcting behavior and increasing stress resistance, and also as a hypnotic. A quick effect was achieved thanks to Teraligen's effect on histamine, serotonin and adrenergic receptors in the form of their blockade.

As already mentioned, Teraligen is used in the complex treatment of endogenous mental disorders, usually in combination with other antipsychotics and antidepressants to reduce the level of agitation, anxiety and tension, which are often observed as part of affective-delusional attacks and major depressive episodes, as well as other affective disorders, continuous schizophrenia and personality disorders. In both cases, Teraligen does not act as the main therapeutic drug, but is often indispensable due to its effectiveness and lack of side effects. Clinical example: patient M., 26 years old. Diagnosis: schizotypal disorder (F21). Programmer, single, lives with parents. Over the course of 10 years, periodic depression has been observed, characterized by low mood with a feeling of inner emptiness, a dull perception of the surrounding life, lack of awareness of one’s feelings and thoughts, and other depersonalization and derealization disorders, which are present to one degree or another outside depressive episodes. Several times he suffered short-term subpsychotic episodes against the background of stressful situations and exogenous hazards. The personality of a patient of the schizoid type with the phenomena of psychophysical juvenileism, with isolation and elements of eccentricity, with unusual hobbies. As preventive and maintenance therapy, the patient takes an atypical antipsychotic with an antidepressant from the serotonin reuptake inhibitor group. During the period of remission, the patient successfully works and studies. With increased workload, the patient experienced asthenic phenomena in the form of increased nervousness, feelings of internal tension, periodic agitation, and difficulty falling asleep. The level of anxiety assessed on the Hamilton HARS scale corresponded to 17 points (average level, closer to high). At that time, a nootropic drug and Teraligen at a dose of 5 mg in the evening were added to the main maintenance regimen. The dose was selected empirically, based on the patient's subjective feelings. While taking Teraligen, already in the first 2-3 days the patient’s sleep improved at night, the feeling of internal tension in the evening significantly decreased, and his mood evened out. After re-evaluation a week later, the level of anxiety underwent a reduction and corresponded to 4 points, i.e. was absent. In this case, Teraligen was used as an adjunctive sedative-hypnotic, and the corresponding effects were associated with effects on histamine and adrenergic receptors. The rapid effect obtained as a result of the use of such small doses was made possible due to the mutually potentiating effect when using various psychotropic drugs.

In all the described cases, the effective dosage was selected individually by titration, and, as can be seen, in a number of cases the drug was effective even in small doses (2.5–5.0 mg/day). None of the described patients had adverse extrapyramidal effects. As is known from general information about the drug, Teraligen is taken orally. The daily dose can be divided into 3-4 doses. Adult patients take 2.5–5.0–10.0 mg per day (hypnotic effect) and more - up to 60–80 mg per day (anxiolytic effect). In a psychotic state, dosages of up to 0.2–0.4 g per day can be used. According to the instructions, drowsiness is observed in the first 3 days of use (regardless of the patient’s age). But it should be noted that the identification of different types of dosing is very arbitrary, because dosage selection is carried out individually. The drug is prescribed to children from 7 years of age [19]. Due to the very wide range of receptor effects and clinical use of Teraligen, the issue of interaction with other drugs becomes relevant [5, 8, 9].

Analysis of the characteristics of the drug’s action allows us to conclude that Teraligen:

• enhances the effect of narcotic analgesics, ethanol, hypnotics, anxiolytic (tranquilizers) and antipsychotic drugs (neuroleptics), as well as drugs for general anesthesia, m-anticholinergic blockers, β-blockers and antihypertensive drugs (dose adjustment required);
• weakens the effect of amphetamine derivatives, m-anticholinergic stimulants, ephedrine, guanethidine, levodopa, dopamine, as well as bromocriptine and increases the concentration of prolactin in the blood serum;
• the use of Teraligen with antiepileptic drugs and barbiturates reduces the threshold of convulsive activity (dose adjustment required);
• tricyclic antidepressants and anticholinergic drugs enhance the m-anticholinergic activity of Teraligen;
• monoamine oxidase inhibitors (simultaneous administration with Teraligen is not recommended) and phenothiazine derivatives increase the risk of arterial hypotension and extrapyramidal disorders;
• when Teraligen is co-administered with drugs that inhibit bone marrow hematopoiesis, the risk of myelosuppression increases;
• hepatotoxic drugs increase the manifestations of hepatotoxicity of the drug Teraligen.

An objective assessment of the effectiveness of the drug is impossible without comparison with other drugs with similar indications for use. Compared to benzodiazepines, Teraligen has an undeniable advantage in the absence of the formation of drug dependence and, therefore, wider possibilities for long-term use [2]. Compared to diphenylmethane derivatives and fabomotizole, Teraligen demonstrates more pronounced anxiolytic activity and the rate of onset of the positive effect [7, 10]. When compared with drugs from the group of minor neuroleptics (periciazine, thioridazine, sulpiride), Teraligen is not inferior to them in terms of the level of sedation and significantly benefits in terms of the virtual absence of side extrapyramidal disorders, in contrast to the above-mentioned drugs, which have quite pronounced side effects [9]; in addition, thioridazine has severe cardiotoxicity, and sulpiride can cause hyperprolactinemia. These undesirable effects are not characteristic of Teraligen. Summarizing all of the above, Teraligen can be characterized as a drug with a wide range of clinical applications not only in psychiatry, but also in neurology and other areas of medicine for the treatment of somatoform, psychosomatic and somatic diseases, incl. and as part of complex therapy. Due to the wide range of dosages, good tolerability and the possibility of long-term use, Teraligen is not only an effective drug, but also extremely convenient to use for both the doctor and the patient.

Interaction

The drug can enhance the effect of anxiolytics , hypnotics , antipsychotics , narcotic analgesics , general anesthesia , antihypertensive drugs and m-anticholinergic drugs . In such cases, it is necessary to adjust the dose.

Teraligen reduces the effectiveness of m-cholinergic stimulants , dopamine , ephedrine , amphetamine , levodopa , guanethidine . Significant depression of the central nervous system is observed when taken simultaneously with drugs that suppress central nervous system functions and ethanol . Combination with barbiturates and antiepileptic drugs leads to a decrease in the threshold of convulsive readiness.

An increase in the plasma concentration of alimemazine is caused by beta-blockers , which can lead to the development of arrhythmia and a decrease in blood pressure.

Teraligen increases the level of prolactin in the blood and reduces the effectiveness of bromocriptine .

The M-anticholinergic activity of alimemazine increases while taking anticholinergics and tricyclic antidepressants .

The risk of extrapyramidal disorders and arterial hypotension increases when taking MAO inhibitors and phenothiazine derivatives .

Reviews of Teraligen

The overall rating given by buyers on the forums is 3.8 out of 5 points. Many patients write about the effectiveness of the drug, its rapid action and the absence of side effects. In addition, there are reviews from customers for whom the drug did not help, and many also write about severe side effects, in particular weakness, drowsiness, and dizziness. Regarding its use for children, reviews are positive. This drug is safe for children as it is very well tolerated.

Doctors' reviews of Teraligen are positive, however, they note that the drug should not be taken without a prescription, as this can only worsen the patient's condition.

There is no data on this drug in the Wikipedia encyclopedia.

Analogs of the drug Teraligen

Teraligen has no analogues for the active substance - alimemazine tartrate. Substitutes that have a similar pharmacological effect belong to the group of neuroleptics.

Remember that the attending physician must prescribe medications, as well as substitutes!

Remember that the attending physician prescribes medications or their analogues

Klopiksol

Clopixol tablets contain zuclopenthixol hydrochloride. Although this is in some sense a substitute for Teraligen, and they are similar in pharmacological action, Klopixol has a stronger antipsychotic effect. Thanks to this, Clopixol is more often used to treat serious mental health disorders: schizophrenia, hallucinations, paranoia, manic states, dementia.

Clopixol is contraindicated in comatose states, acute poisoning by barbiturates, alcohol, opiates, pregnancy and breastfeeding. Clopixol, unlike Teraligen, is better tolerated by patients. Side effects are similar to Teraligen, but occur even less frequently and are not as pronounced.

Conapax

It is also an antipsychotic drug based on thioridazine hydrochloride. Sonapax has a more pronounced antihistamine and anticholinergic effect compared to other neuroleptics. Indicated for use in those cases described in the instructions for Teraligen. But it can be used to treat children from 4 years of age. Conapax is contraindicated in comatose states, acute depression, porphyria, pheoxomocytoma, hematopoietic disorders, in the first trimester and in the last week of pregnancy, during lactation tions. Sonapax is well tolerated, it can be taken by children, and its price is lower than Teraligen.

Chloprothixene Zentiva

The main active ingredient of Sanofi Chloprothixene tablets is chlorprothixene. Medicines are indicated for the treatment of: psychoses, schizophrenia, depressive states, mental disorders during menopause and for diseases of the brain (traumatic brain injuries, enc ephalopathy), alcoholic delirium, sleep disorders caused by psychosomatic and neurotic disorders, insomnia due to burns, skin diseases, accompanied by itching. Contraindications for use: hypersensitivity, coma, poisoning with drugs that depress nervous activity. When taking tablets, in addition to the side effects characteristic of Teraligen, disorders of the mammary glands and reproductive organs are possible: galactorrhea, amenorrhea, gynecomastia, c decreased libido.

Pipolfen

This is a Hungarian analogue of Teraligen based on promethazine hydrochloride. It is often used as a sedative for postoperative pain (in combination with analgesics), allergic diseases and other cases. Pipolfen has a fairly large list of contraindications and age restrictions, so before treatment, be sure to consult a specialist and read the instructions.

Teraligen price, where to buy

In Russia, the average price for a package of 25 tablets is 282 rubles, for 50 tablets - 465 rubles.

• Online pharmacies in RussiaRussia

ZdravCity

• Teraligen solution for intramuscular injection.
  input 5mg/ml amp. 5ml 10 pcs. Federal State Budgetary Institution "RKNPK" of the Ministry of Health of Russia - EPMBP 1033 rub. order
• Teraligen retard tab. with prolong. release p/o captivity 20mg No. 30AO Valenta Pharmaceuticals

  RUB 1,423 order

• Teraligen tab. p/o captivity. 0.005g 50pcs JSC Valenta Pharmaceuticals

  RUB 867 order

• Teraligen tab. p/o captivity. 25pcs JSC Valenta Pharmaceuticals

  RUR 649 order

• Teraligen tab. p/o captivity. 100pcs JSC Valenta Pharmaceuticals

  RUB 1,417 order