periciazine

Action and Spectrum

Actions and spectrum: 

Action:

periciazine works by blocking the activity of dopamine receptors, specifically D2 receptors, in the brain. By doing so, it reduces the effects of excessive dopamine signalling, which is associated with psychotic symptoms like delusions and hallucinations. Additionally, periciazine also has some affinity for serotonin receptors, particularly the 5-HT2 receptors. 

Spectrum:  

• Schizophrenia: periciazine is prescribed to manage the positive symptoms of schizophrenia, like hallucinations, delusions, and disorganized thinking. It helps to reduce intensity & frequency of these symptoms. 
• Other Psychotic Disorders: It is also used to treat schizoaffective disorder and psychotic symptoms associated with mood disorders. 
• Behavioural Disturbances: periciazine may be used to manage behavioural disturbances in elderly patients with dementia-related psychosis. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Neuroleptic malignant syndrome 

altered cardiac conduction 

orthostatic hypotension 

blood dyscrasias 

oesophageal dysmotility 

extrapyramidal symptoms 

acute dystonic reactions 

tardive dyskinesia 

glucose intolerance 

diabetic ketoacidosis 

QT prolongation 

venous thromboembolism 

aspiration 

Pseudoparkinsonism 

Akathisia 

hyperprolactinaemia 

pigmentary retinopathy 

weight gain 

Hyperglycaemia 

Black Box Warning

Black Box Warning: 

There were no specific black box warnings associated with the use of periciazine. 

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• Hypersensitivity: Individuals who have a known hypersensitivity or allergy to periciazine or any of its components should not use this medication. 
• Coma: periciazine is contraindicated in patients with central nervous system depression, including those in a coma. 
• Severe Central Nervous System Depression: Due to its sedative effects, periciazine may exacerbate central nervous system depression in conditions like alcohol intoxication, drug overdose, or severe brain injury. 
• Blood Dyscrasias: The use of periciazine may be contraindicated in individuals with certain blood disorders, such as bone marrow depression or blood dyscrasias. 
• Angle-Closure Glaucoma: periciazine can cause anticholinergic effects, including pupil dilation, and is contraindicated in individuals with angle-closure glaucoma. 
• Substance Abuse: The potential for misuse or exacerbation of substance abuse may make periciazine use contraindicated in individuals with a history of substance abuse. 
• Concomitant Use of Certain Medications: There may be interactions between periciazine and certain medications, such as monoamine oxidase inhibitors (MAOIs), and their concomitant use could be contraindicated due to potential adverse effects.

Caution: 

• Cardiovascular Effects: Antipsychotic medications can lead to changes in heart rate, blood pressure, and the risk of arrhythmias. 
• Central Nervous System Effects: Antipsychotics, including periciazine, can cause sedation, dizziness, and impaired alertness.  
• Extrapyramidal Symptoms (EPS): These are movement disorders associated with antipsychotic use and can include symptoms such as tremors, stiffness, and akathisia (restlessness). Caution is advised in patients who may be at higher risk of developing EPS, such as the elderly. 
• Hyperglycemia and Diabetes: Antipsychotic medications may contribute to elevated blood glucose levels. Patients with a history of diabetes or those at risk for developing diabetes should be monitored for changes in blood sugar levels. 
• Elderly Population: Elderly patients may be more sensitive to the sedative and anticholinergic effects of antipsychotic medications. Caution is recommended when prescribing antipsychotics to older adults. 
• Renal and Hepatic Impairment: Patients with impaired kidney or liver function may require dose adjustments or careful monitoring when taking antipsychotic medications.

Comorbidities: 

• Cardiovascular Conditions: Patients with cardiovascular disorders such as heart disease, hypertension, arrhythmias, and a history of heart attacks may require cautious use of periciazine. The medication’s potential to affect heart rate and blood pressure could exacerbate these conditions. 
• Diabetes and Metabolic Disorders: periciazine, like some other antipsychotics, may contribute to weight gain and metabolic changes, which could be concerning for individuals with diabetes, obesity, or metabolic syndrome. 
• Seizure Disorders: Antipsychotic medications can lower the seizure threshold, potentially triggering seizures in individuals with epilepsy or a history of seizures. 
• Movement Disorders: Individuals with a history of movement disorders such as Parkinson’s disease should use periciazine cautiously due to the potential to worsen extrapyramidal symptoms. 
• Respiratory Disorders: Patients with chronic obstructive pulmonary disease (COPD), asthma, or other respiratory conditions may experience increased sedation due to periciazine’s central nervous system effects. 
• Glaucoma: periciazine’s anticholinergic effects can lead to pupil dilation and increased intraocular pressure. Caution is advised in individuals with narrow-angle glaucoma. 

Pregnancy / Lactation

Pregnancy consideration: Pregnancy Category: not assigned 

Lactation: excreted into breast milk: unknown  

Pregnancy category: 

• Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 
• <b>Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   
• Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits. 
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women. 
• Category N: There is no data available for the drug under this category. 

Pharmacology

Pharmacology: 

periciazine is a typical or first-generation antipsychotic medication that exerts its pharmacological effects by antagonizing dopamine receptors, particularly the D2 subtype, in the brain. By blocking these receptors, periciazine reduces the activity of dopamine, a neurotransmitter implicated in the pathophysiology of psychotic disorders.

This antagonistic action helps alleviate positive symptoms of psychosis, such as hallucinations and delusions. Additionally, periciazine also exhibits some affinity for serotonin receptors, particularly the 5-HT2 receptors, which may contribute to its antipsychotic effects. The pharmacological profile of periciazine involves a combination of dopamine and serotonin receptor modulation, contributing to its therapeutic action in managing various psychotic disorders. 

Pharmacodynamics: 

• Dopamine Receptor Antagonism: periciazine exerts its primary pharmacodynamic effect by blocking dopamine receptors, particularly the D2 subtype. By antagonizing these receptors, periciazine reduces the activity of dopamine, a neurotransmitter associated with positive symptoms of psychosis like hallucinations and delusions. This dopamine receptor blockade contributes to the antipsychotic action of periciazine. 
• Serotonin Receptor Modulation: While periciazine’s main mechanism of action is related to dopamine receptors, it also exhibits some affinity for serotonin receptors, particularly the 5-HT2 subtype. This modulation of serotonin receptors may contribute to its overall antipsychotic effects and may help manage a broader range of symptoms in certain individuals. 
• Extrapyramidal Symptoms (EPS): As a first-generation antipsychotic, periciazine’s dopamine receptor blockade can lead to extrapyramidal symptoms (EPS) such as dystonia, akathisia, parkinsonism, and tardive dyskinesia. These motor side effects are associated with disruptions in the brain’s motor control pathways and can impact movement and muscle control. 
• Anticholinergic Effects: periciazine’s antagonism of muscarinic acetylcholine receptors can result in anticholinergic effects such as dry mouth, blurred vision, constipation, and urinary retention. 
• Sedation: periciazine can have sedative effects due to its action on histamine H1 receptors in the brain, contributing to drowsiness and a calming effect.

Pharmacokinetics: 

Absorption 

periciazine is administered orally as tablets or capsules. It is well-absorbed from the gastrointestinal tract after oral administration. The absorption process determines how quickly the medication enters the bloodstream and starts exerting its effects. 

Distribution 

periciazine is distributed throughout the body, including the central nervous system, due to its lipophilic nature. It crosses blood-brain barrier, allowing it to reach its target sites in the brain where it exerts its antipsychotic effects. 

Metabolism 

periciazine undergoes extensive hepatic (liver) metabolism. It is metabolized by various liver enzymes, including the cytochrome P450 (CYP) enzyme system, into several active and inactive metabolites. Metabolism is a crucial process that prepares the medication for elimination from the body. 

Elimination and excretion 

The metabolites of periciazine, along with some unchanged drug, are excreted primarily through the urine. This elimination process removes the medication and its metabolites from the body. 

Adminstartion

Administration: 

• Dosage: The dosage of periciazine is determined based on the patient’s needs, the severity of their condition, and their response to the medication. It is important to follow the prescribed dosage exactly as instructed. 
• Frequency: periciazine is usually taken once or twice a day. The dosing frequency will be determined by the healthcare provider and should be followed consistently. 
• Timing: periciazine can be taken with or without food, but it is important to follow the specific instructions provided by the healthcare provider. Taking it at the same time each day can help maintain consistent levels of the medication in the bloodstream. 
•  Swallowing: Take the tablets or capsules with a glass of water. Do not crush, break, or chew extended-release formulations unless advised by the healthcare provider. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: periciazine 

Pronounced: (per-uh-SYE-uh-zeen)  

Why do we use periciazine? 

• Psychosis: periciazine is primarily prescribed to treat psychotic disorders such as schizophrenia. It helps alleviate symptoms associated with psychosis, including hallucinations, delusions, disorganized thinking, and social withdrawal. 
• Mania: periciazine can also be used as an adjunctive treatment for manic episodes associated with bipolar disorder. It may help stabilize mood and reduce the severity of manic symptoms. 
• Agitation: periciazine’s sedative effects make it useful for managing acute agitation and aggressive behaviour in individuals with psychiatric conditions. 
• Anxiety: In some cases, periciazine has been used off-label to manage anxiety symptoms. However, its use for this purpose may be less common compared to other medications indicated for anxiety.