Medication Information:
Pimozide (generic) - Orap (brand)

Manufacturer: Gate Pharmaceuticals, Sellersville, PA
Classification: Tic suppressor
Common Usage: Tourette's disorder

Common Major Side Effects: Extrapyramidal symptoms, especially during the first week of treatment, include akathisia (motor restlessness) and dystonia (muscle spasms). Rarely experienced side effects include electrocardiographic (EKG) changes; grand mal seizures (in doses above 20 mg/day); neuroleptic malignant syndrome, a disorder that can cause muscle rigidity, irregular pulse and acute renal failure; mental changes, fever; and sedation. Use with caution when performing potentially hazardous tasks such as driving a car or operating machinery, especially during the first few days of therapy or after dosage increases. Use with caution in patients with impaired liver or kidney function, or in patients with a history of seizures or tardive dyskinesia.

Interactions with Other Medications: Use this drug with caution with other drugs that can affect EKG results such as phenothiazines (Compazine, Mellaril), tricyclic antidepressants (Elavil, Triavil), or antiarrhythmic agents (Lanoxil, Inderal). Use this drug with caution with macrolide antibiotics (Biaxin, Erytlirocin), which also may cause changes in EKG results. This drug may increase the effect of other drugs that suppress the central nervous system, such as pain medications (Percodan, Darvon), sedatives (Nembutal, Seconal) and alcohol. Avoid use of this drug in patients on anticonvulsant medications (Dilantin, Depakote), because it may lower the threshold for seizures This drug should not be used in patients taking other drugs that may cause tics such as Cylert, Ritalin or Adderall to determine if those drugs instead of Tourette's disorder are causing the tics.

Common Dosages: Starting dose is usually 1 to 2 mg a day in divided doses. The dose may be increased every other day up to 10 mg a day, depending on the patient's weight. Reliable dosing information for children younger than age 12 is unavailable.

Identification: This drug is available in 2 mg white tablets that are scored and contain the names "Lemmon" and "Orap 2."

Storage: Store in a tight, light-resistant container.

Edited by Stephen R. Sakiad, PharmD

A SERVICE OF…. Psychopharmacology Update
Note: These guidelines are for general information only. For more specific information, consult your physician or pharmacist.