Chemistry:Pecazine
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| Trade names | Pacatal, Pacatol, Paxital, Lacumin, Nothiazine |
| Routes of administration | Oral, parenteral |
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| Formula | C19H22N2S |
| Molar mass | 310.46 g·mol−1 |
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Pecazine (INN), also known as mepazine (trade name Pacatal), is a phenothiazine formerly used as a neuroleptic drug or major tranquilizer.
Pecazine was first synthesized in 1953 by Wilhelm Schuler and Otto Nieschulz and was quickly incorporated into psychiatric practice as an ataractic, i.e., a true tranquilizer rather than a hypnotic or depressant. It was considered interchangeable with chlorpromazine, albeit with a different side effect profile, which included less sedation and a lower risk of extrapyramidal symptoms due to its potent parasympatholytic and anticholinergic effect.[1]
As early as 1958, however, studies reported inferiority to other phenothiazines in the treatment of schizophrenia and questioned its place in the clinic;[2][3] in 1960, a double-blind, randomized controlled trial found pecazine to be no more effective than placebo.[4] Subsequent research found that, like the structurally related promethazine, pecazine is essentially devoid of antipsychotic activity.[5]
Pecazine was implicated in a number of cases of agranulocytosis and was subsequently withdrawn from the market.[6][7][8][9] More recently, it has become a subject of research interest as a MALT1 and RANKL inhibitor.[10][11]
References
- ↑ "The ataractic drugs: the present position of chlorpromazine, Frenquel, Pacatal, and reserpine in the psychiatric hospital". Am J Psychiatry 113 (6): 530–9. December 1956. doi:10.1176/ajp.113.6.530. PMID 13372821.
- ↑ "The place of pacatal in psychiatry". Postgrad Med J 34 (397): 605–8. November 1958. doi:10.1136/pgmj.34.397.605. PMID 13591077.
- ↑ "Treatment of schizophrenic reactions with phenothiazine derivatives. A comparative study of chlorpromazine, triflupromazine, mepazine, prochlorperazine, perphenazine, and phenobarbital". Am J Psychiatry 117: 97–105. August 1960. doi:10.1176/ajp.117.2.97. PMID 13808146.
- ↑ "Mepazine (pacatal): clinical trial with placebo control and psychological study". Psychopharmacologia 1 (4): 280–7. June 1960. doi:10.1007/BF00404225. PMID 13844495.
- ↑ "Inhibition and potentiation of apomorphine-induced hypermotility in rats by neuroleptics". Eur. J. Pharmacol. 36 (2): 385–93. April 1976. doi:10.1016/0014-2999(76)90092-3. PMID 1278230.
- ↑ "Agranulocytosis during treatment with pacatal". Lancet 271 (6952): 1081. November 1956. doi:10.1016/s0140-6736(56)90213-6. PMID 13377680.
- ↑ "Fatal agranulocytosis during treatment with pacatal". Am J Psychiatry 113 (9): 842–3. March 1957. doi:10.1176/ajp.113.9.842. PMID 13402978.
- ↑ "Agranulocytosis during mepazine therapy". Med. J. Aust. 44 (20): 726–7. November 1957. doi:10.5694/j.1326-5377.1957.tb60246.x. PMID 13492769.
- ↑ "Agranulocytosis after 10(N-methyl-piperdyl-3-methyl)phenothiazine, with recovery". N. Engl. J. Med. 258 (6): 287. February 1958. doi:10.1056/NEJM195802062580608. PMID 13504461.
- ↑ "Pharmacologic inhibition of MALT1 protease by phenothiazines as a therapeutic approach for the treatment of aggressive ABC-DLBCL". Cancer Cell 22 (6): 825–37. December 2012. doi:10.1016/j.ccr.2012.11.002. PMID 23238017.
- ↑ "Structural analysis of phenothiazine derivatives as allosteric inhibitors of the MALT1 paracaspase". Angew. Chem. Int. Ed. Engl. 52 (39): 10384–7. September 2013. doi:10.1002/anie.201304290. PMID 23946259.
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