Pipotiazine palmitate compared to oral antipsychotics for schizophrenia[3]
Summary
Although well-conducted and reported randomized trials are still needed to fully inform practice (no trial data exists reporting hospital and services outcomes, quality of life, satisfaction with care and economics) pipotiazine palmitate is a viable choice for both clinician and person with schizophrenia.[3]
Outcome
Findings in words
Findings in numbers
Quality of evidence
Global outcomes
No important clinical response Follow-up: by 3 week)
There is no clear difference between people given pipotiazine palmitate and those receiving oral antipsychotics. These findings are based on data of low quality.
Pipotiazine palmitate may increase the chance of leaving the study early but the difference between people given pipotiazine palmitate and those receiving oral antipsychotics is not clear. These findings are based on data of low quality.
Oral antipsychotic drugs and pipotiazine palmitate carry similar risks of this problematic movement disorder. These findings are based on data of low quality.
Pipotiazine palmitate may slightly reduce the chance of experiencing this movement disorder but there is no clear difference between people given pipotiazine palmitate and those receiving oral antipsychotics. These findings are based on data of low quality.
Pipotiazine palmitate is contraindicated in people with circulatory collapse (shock), altered states of consciousness, including drug intoxication, or other serious health conditions (liver disease, kidney disease, pheochromocytoma, severe cardiovascular disease, or blood dyscrasias). It is contraindicated in people with severe depression. Pipotiazine palmitate should not be used in people who have a history of allergic reactions to any component of the medicine or to chemically similar medicines (phenothiazines).[4]
Pharmacokinetics
Pipotiazine was available as a long-acting injectable formulation (pipotiazine palmitate). After deep intramuscular injection, pipotiazine palmitate reaches maximum plasma concentration in 7-14 days, has an elimination half-life of 15 days, and reaches steady-state levels after 2 months of usual dosing (given every 4 weeks).[5]
The alkylation of 2-Dimethylaminosulfonylphenthiazine [1090-78-4] (1) with 1-Bromo-3-chloropropane (2) gives 10-(3-chloropropyl)-N,N-dimethylphenothiazine-2-sulfonamide [40051-12-5] (3). Alkylation with 4-Piperidineethanol [622-26-4] (4) completes the synthesis of Pipothiazine (5).
History
The long-acting injectable formulation of pipotiazine (pipotiazine palmitate) was withdrawn from all markets globally in March 2015 due to a shortage of the active ingredient.[9]
References
↑"A double-blind controlled trial of pipotiazine, haloperidol and placebo in recently-hospitalized acute schizophrenic patients". Brazilian Journal of Medical and Biological Research16 (4): 305–11. December 1983. PMID6143579.
↑ZA6801990 idem Jean-Claude Rene Georg Blondel, 2 More », U.S. Patent 3,875,156 (1975 to Rhone Poulenc Sa).
↑Schussen, & Li Haixia, et al. CN patent 106568857 (2019 to YUEYANG XINHUADA PHARMACEUTICAL CO Ltd).
↑"Guidance on switching away from Piportil Depot® (pipotiazine palmitate) injection". The British Journal of Psychiatry206 (6): 521. June 2015. doi:10.1192/bjp.206.6.521. PMID26034183.
