How pipamperone works
Chemically, pipamperone is a so-called butyrophenone and thus belongs to the same class of active ingredients as haloperidol. In contrast to haloperidol, however, pipamperone has only a weak antipsychotic effect, but a stronger sedative and depressant effect.
This balance of messenger substances is disturbed in people who suffer from sleep disorders or physical restlessness. Pipamperon can restore it by blocking certain docking sites (receptors) of dopamine – the patient becomes calmer and can sleep better.
The favorable side effect profile (including no dry mouth, constipation, vision problems) makes pipamperone a beneficial drug for the elderly.
Absorption, breakdown and excretion
Degradation then takes place in the liver. The breakdown products are then excreted in the urine via the kidneys.
When is pipamperone used?
The indications for use (indications) of pipamperone include:
- Sleep disorders
- psychomotor agitation
How Pipamperon is used
What are the side effects of pipamperone?
Very often, i.e. in more than ten percent of those treated, drowsiness and the so-called “cogwheel phenomenon” occur. Patients can no longer stretch out their arms and legs in a flowing movement, but only jerkily in small individual movements.
Rarely, i.e. in less than 0.1 percent of those treated, the use of pipamperone leads to convulsions, headaches and secretion of the mammary glands.
Very rarely, the so-called “malignant neuroleptic syndrome” develops. In this case, tremors and high fever occur. As a result, muscle breakdown may occur, which must be treated immediately. In about 20 percent of cases, malignant neuroleptic syndrome is fatal despite treatment.
Contraindications
Medications containing pipamperone must not be used in:
- Parkinson’s disease
- conditions with central nervous system dullness
Drug interactions
When taken at the same time, pipamperone and the following substances may increase each other’s effects:
- antidepressants
- Analgesics
- central depressants (e.g. hypnotics, psychotropic drugs, antihistamines)
Drugs containing pipamperone reduce the effect of levodopa and bromocriptine. Both agents are administered in Parkinson’s disease.
Simultaneous use with pipamperone may decrease the effect of antihypertensive drugs. Combination with other drugs that may also prolong the QT interval (e.g., antiarrhythmics, macrolide antibiotics, antimalarials) or lead to potassium deficiency (hypokalemia) (such as certain diuretics) should be avoided.
Medication with pipamperone may impair the ability to react. Therefore, one should not actively participate in road traffic or operate heavy machinery during treatment.
Age restrictions
Children and adolescents under 18 years of age may receive pipamperone only after a strict benefit-risk assessment by a doctor.
Pregnancy and lactation
Better-tested alternatives are promethazine (for restlessness and agitation) and amitriptyline and diphenhydramine (for sleep disorders).
How to get medicines with pipamperone
Medicines containing pipamperone require a prescription in Germany and Switzerland and are therefore only available from pharmacies with a prescription from a doctor. In Germany, the active ingredient is available as a tablet, juice, or oral solution, whereas in Switzerland it is only available as a tablet.
How long has pipamperone been known?
The active ingredient pipamperone belongs to a group of active ingredients that have been used for a long time (first-generation antipsychotics). In the meantime, second-generation antipsychotics (so-called “atypical antipsychotics”) have been developed on this basis.
