Pipotiazine

Toxicity

Symptoms of overdose include severe extrapyramidal manifestations, hypotension, lethargy and sedation.

Originator

Piportil, Rhone-Poulenc Rorer

The Uses of Pipotiazine

Pipotiazine is drug repurposing for Covid-19: discovery of potential small-molecule inhibitors of spike protein-ACE2 receptor interaction through virtual screening and consensus scoring.

The Uses of Pipotiazine

Antipsychotic.

Indications

For the maintenance treatment of chronic non-agitated schizophrenic patients.

Background

Pipotiazine has actions similar to those of other phenothiazines. Among the different phenothiazine derivatives, it appears to be less sedating and to have a weak propensity for causing hypotension or potentiating the effects of CNS depressants and anesthetics. However, it produces a high incidence of extra pyramidal reactions. It is used for the maintenance treatment of chronic non-agitated schizophrenic patients. Symptoms of overdose include severe extrapyramidal manifestations, hypotension, lethargy and sedation.

Manufacturing Process

10-(3-Tetrahydropyranyloxypropyl)phenthiazine-2-sulfonic acid dimethylamide prepared by condensing 1-chloro-3-tetrahydropyranyloxy propane with phenthiazine-2-sulfonic acid dimethylamide (melting point 140°C) in xylene in the presence of sodamide.
10-(3-Hydroxypropyl)phenthiazine-2-sulfonic acid dimethylamide was prepared by the action of hydrochloric acid in ethanol on 10-(3tetrahydropyranyloxypropyl)phenthiazine-2-sulfonic acid dimethylamide.
10-(3-Methanesulphonyloxypropyl)phenthiazine-2-sulphonic acid dimethylamide, was obtained by condensing methanesulphonyl chloride in anhydrous pyridine with 10-(3-hydroxypropyl)phenthiazine-2-sulfonic acid dimethylamide.
10-(3-Methanesulphonyloxypropyl)phenthiazine-2-sulfonic acid dimethylamide and 4-hydroxyethyl piperidine in toluene were heated under reflux with stirring. The reaction mixture was allowed to cool and water was added. The resulting toluene solution layer was decanted and washed twice with water. The toluene solution was then stirred with 5% hydrochloric acid. The hydrochloride of the desired phenthiazine base precipitated in gummy condition in the aqueous layer. This was decanted and treated with sodium hydroxide. It was then extracted three times with ethyl acetate. The extracts were dried over sodium sulfate, filtered and concentrated in vacuum. A resinous product was obtained. This product was dissolved in a mixture of benzene and cyclohexane and chromatographed on a column containing alumina. The chromatographed product was eluted successively with mixtures of benzene and cyclohexane and then with benzene and finally with a mixture of benzene and ethyl acetate. The eluates were evaporated to yield a crude product. This product was recrystallised from aqueous ethanol and yielded 10[3-[4-(2-hydroxyethyl)piperidyl]propyl]phenthiazine-2-sulfonic acid dimethylamide.

Therapeutic Function

Neuroleptic

Pharmacokinetics

Pipotiazine has actions similar to those of other phenothiazines. Among the different phenothiazine derivatives, it appears to be less sedating and to have a weak propensity for causing hypotension or potentiating the effects of CNS depressants and anesthetics. However, it produces a high incidence of extra pyramidal reactions. It reduces activity of dopamine receptors in the limbic system. Its 5-HT antagonism helps normalize dopamine activity in the cortical regions.

Metabolism

Not Available