general
- Generic Name : Zotepine
- Therapeutic Classification : Antipsychotics
- Trade Names/Brand Names of Zotepine(India) : Sirilept (25mg), Sirilept (100mg), Sirilept (50mg)
prescription
Zotepine, primarily indicated for schizophrenia, also shows promise in treating mania based on clinical trials.
risk factors
- Breastfeeding mothers: Potential harm to the baby via breast milk. Avoid in pregnancy, especially in the third trimester, due to risk of abnormal muscle movements and breathing difficulties in newborns
- History of seizures in self or family
- Prolonged QT interval on ECG
- Concomitant use with sibutramine (an obesity medication banned in many countries)
- Children under 18
- Allergy to zotepine
- Acute gout or history of kidney stones
- Elderly patients with dementia
- Concurrent use with other CNS depressants like alcohol
- Elderly patients should monitor blood pressure before initiating zotepine treatment and during the initial weeks of treatment.
- Regular monitoring of ECG, electrolyte levels, complete blood cell count, and liver function tests is necessary.
- Avoid rapid discontinuation of zotepine to prevent rebound psychosis; gradual dose reduction is recommended.
side effects
- Gastrointestinal: Diarrhea, dyspepsia, constipation, dry mouth.
- Central Nervous System: Anxiety, depression, agitation, headache, insomnia, body temperature fluctuations, drowsiness, seizures, hyperprolactinemia.
- Cardiovascular: Increased heart rate, decreased blood pressure, cardiac rhythm disturbances.
- Eye: Blurred vision, angle-closure glaucoma.
- Others: Movement disorders (tardive dyskinesia), neuroleptic malignant syndrome, elevated liver enzymes, weight gain, sweating, abnormal blood cell counts, weakness.
dosage
The initial dose is 25 mg three times daily. Dosage adjustments can be made based on physician guidance, with a maximum dose of 100 mg three times daily or 75 mg three times daily in elderly patients.
how to take
Zotepine is available as a tablet for oral administration, to be taken with or without food.
warning
- Immediate cessation of zotepine is necessary if neuroleptic malignant syndrome develops, a life-threatening reaction associated with antipsychotic medications.
- Monitor weight, especially in patients with diabetes or high cholesterol, as zotepine use can lead to weight gain.
- Avoid alcohol consumption due to additive effects with zotepine.
- Exercise caution in patients with liver or kidney impairment, adjusting dosage as necessary.
- Use with caution in patients with angina, heart disease, severe hypertension, prostate enlargement, urinary retention, angle-closure glaucoma, paralytic ileus, Parkinson’s disease, or adrenal medulla tumors.
storage
Room Temperature (25°C)