Periciazine
{{short description|Typical antipsychotic medication}}
{{Drugbox
| Verifiedfields = changed
| UNII_Ref = {{fdacite|correct|FDA}}
| UNII = 3405M6FD73
| verifiedrevid = 437139007
| IUPAC_name = 10-[3-(4-hydroxypiperidin-1-yl)propyl]-10H-phenothiazine-2-carbonitrile
| image = Periciazine.svg
| image_class = skin-invert-image
| width = 260
| CAS_number_Ref = {{cascite|correct|??}}
| CAS_number = 2622-26-6
| CAS_supplemental =
| ATC_prefix = N05
| ATC_suffix = AC01
| ATC_supplemental =
| PubChem = 4747
| ChEMBL_Ref = {{ebicite|changed|EBI}}
| ChEMBL = 251940
| ChEBI_Ref = {{ebicite|changed|EBI}}
| ChEBI = 31981
| DrugBank_Ref = {{drugbankcite|changed|drugbank}}
| DrugBank = DB01608
| ChemSpiderID_Ref = {{chemspidercite|changed|chemspider}}
| ChemSpiderID = 4585
| KEGG_Ref = {{keggcite|correct|kegg}}
| KEGG = D01485
| chemical_formula =
| C=21 | H=23 | N=3 | O=1 | S=1
| smiles = C1CN(CCC1O)CCCN2C3=CC=CC=C3SC4=C2C=C(C=C4)C#N
| StdInChI_Ref = {{stdinchicite|changed|chemspider}}
| StdInChI = 1S/C21H23N3OS/c22-15-16-6-7-21-19(14-16)24(18-4-1-2-5-20(18)26-21)11-3-10-23-12-8-17(25)9-13-23/h1-2,4-7,14,17,25H,3,8-13H2
| StdInChIKey_Ref = {{stdinchicite|changed|chemspider}}
| StdInChIKey = LUALIOATIOESLM-UHFFFAOYSA-N
| bioavailability =
| protein_bound =
| metabolism = Hepatic (mostly via conjugation)
| excretion = Renal
| pregnancy_AU = C
| pregnancy_US =
| pregnancy_category=
| legal_AU = S4
| legal_BR = C1
| legal_BR_comment = {{Cite web |author=Anvisa |author-link=Brazilian Health Regulatory Agency |date=2023-03-31 |title=RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial |trans-title=Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control|url=https://www.in.gov.br/en/web/dou/-/resolucao-rdc-n-784-de-31-de-marco-de-2023-474904992 |url-status=live |archive-url=https://web.archive.org/web/20230803143925/https://www.in.gov.br/en/web/dou/-/resolucao-rdc-n-784-de-31-de-marco-de-2023-474904992 |archive-date=2023-08-03 |access-date=2023-08-16 |publisher=Diário Oficial da União |language=pt-BR |publication-date=2023-04-04}}
| legal_CA = Rx-only
| legal_UK = POM
| legal_US =
| legal_status = Rx-only
| routes_of_administration = Oral
| class = Typical antipsychotic
}}
Periciazine (INN), also known as pericyazine (BAN) or propericiazine, is a drug that belongs to the phenothiazine class of typical antipsychotics.
Periciazine is not approved for sale in the United States. It is commonly sold in Canada, Italy and Russia under the tradename Neuleptil and in United Kingdom and Australia under the tradename Neulactil.{{cite book|title=Pericyazine|work=Martindale: The Complete Drug Reference|publisher=The Royal Pharmaceutical Society of Great Britain|date=23 September 2011|access-date=2 November 2013|url=http://www.medicinescomplete.com/mc/martindale/current/7082-t.htm}}
Medical uses
The primary uses of periciazine include in the short-term treatment of severe anxiety or tension and in the maintenance treatment of psychotic disorders such as schizophrenia. There is insufficient evidence to determine whether periciazine is more or less effective than other antipsychotics. A 2014 systematic review compared periciazine with typical antipsychotics for schizophrenia:
| class="wikitable"
|+ Periciazine versus typical antipsychotic for schizophrenia{{cite journal | vauthors = Matar HE, Almerie MQ, Makhoul S, Xia J, Humphreys P | title = Pericyazine for schizophrenia | journal = The Cochrane Database of Systematic Reviews | volume = 2014 | issue = 5 | pages = CD007479 | date = May 2014 | pmid = 24825770 | url = http://www.cochrane.org/CD007479/SCHIZ_pericyazine-for-the-treatment-of-schizophrenia | doi = 10.1002/14651858.CD007479.pub2 | doi-access = | pmc = 11023599 }} | |||
| Summary | |||
|---|---|---|---|
| On the basis of very low quality evidence it is not possible to determine the effects of periciazine in comparison with antipsychotics such as chlorpromazine or trifluoperazine for the treatment of schizophrenia. There is some evidence, however, that periciazine may be associated with a higher incidence of extrapyramidal side effects than other antipsychotics. | |||
| style="padding:0;" |
{| class="wikitable collapsible collapsed" style="width:100%;" | |||
| scope="col" style="text-align: left;"| Outcome
! scope="col" style="text-align: left;"| Findings in words ! scope="col" style="text-align: left;"| Findings in numbers ! scope="col" style="text-align: left;"| Quality of evidence | |||
| colspan="4" style="text-align: left;"| Global state | |||
| Not improved Follow-up: 6-12 weeks | Periciazine may increase the risk of being 'not improved', but, at present it is not possible to be confident about the difference between people receiving periciazine and those given chlorpromazine or trifluoperazine. Data supporting this finding are very limited. | RR 1.24 (0.93 to 1.66) | Very low |
| colspan="4" style="text-align: left;"| Adverse events | |||
| Extrapyramidal side effect Follow-up: 6-12 weeks | Periciazine may reduce the chance of experiencing the movement disorder, compared with chlorpromazine or trifluoperazine, but, at present there is only very limited data supporting this finding. | RR 0.59 (0.38 to 0.89) | Very low |
| colspan="4" style="text-align: left;"| Leaving the study early | |||
| For any reasons Follow-up: 9-12 weeks | Periciazine may reduce the chance of leaving the study early, but, at present it is not possible to be confident about the difference between the two treatments and data supporting this finding are very limited. | RR 0.46 (0.11 to 1.9) | Very low |
| colspan="4" style="text-align: left;"| Missing outcomes | |||
| No study reported any data on outcomes such as relapse, mental state, cost-effectiveness, and information relating to behavior |
|}
Periciazine has also been studied in the treatment of opioid dependence.{{cite journal | vauthors = ((Sivolap IuP)), Savchenkov VA | title = [The use of neuroleptics in treating opiate dependence] | language = ru | journal = Zhurnal Nevrologii I Psikhiatrii imeni S.S. Korsakova | volume = 99 | issue = 6 | pages = 29–34 | year = 1999 | pmid = 10441864 }}
Adverse effects
Periciazine is a rather sedating and anticholinergic antipsychotic, and despite being classed with the typical antipsychotics, its risk of extrapyramidal side effects is comparatively low.{{cite web|title=Approximate relative frequency (not intensity) of common adverse effects of antipsychotics (Table 8.21) [NB1]|date=February 2013|access-date=2 November 2013|url=http://etg.tg.com.au/conc/desktop/index.htm?id=75114e7800512079b341de7fb82c953c|work=eTherapeutic Guidelines complete|publisher=Therapeutic Guidelines Limited}}{{dead link|date=March 2018 |bot=InternetArchiveBot |fix-attempted=yes }} It has a relatively high risk of causing hyperprolactinaemia and a moderate risk of causing weight gain and orthostatic hypotension.
Synthesis
File:Pericyazine synthesis.svg
The final step in the synthesis involves the alkylation of 3-(2-cyanophenothiazin-10-yl)propyl 4-methylbenzenesulfonate, [https://pubchem.ncbi.nlm.nih.gov/compound/134990672 CID:134990672] (1) with 4-Piperidinol [5382-16-1] (2) giving Periciazine (3).
References
{{Reflist|2}}
External links
- [https://web.archive.org/web/20060427012310/http://emc.medicines.org.uk/emc/assets/c/html/DisplayDoc.asp?DocumentID=15171 Neulactil - Summary of Product Characteristics] from the electronic Medicines Compendium
- [https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-PI-05922-3] from the Therapeutic Goods Administration.
- [https://web.archive.org/web/20131103071954/http://webprod5.hc-sc.gc.ca/dpd-bdpp/item-iteme.do?pm-mp=00018707] from Health Canada.
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