The Basics
What is Pimozide?
It can treat Tourette syndrome.
Brand names for Pimozide
Orap
How Pimozide is classified
Antipsychotic Agents
Pimozide During Pregnancy
Pimozide pregnancy category
Category N/ANote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Pimozide while pregnant
Reproduction studies performed in rats and rabbits at oral doses up to 8 times the maximum human dose did not reveal evidence of teratogenicity. In the rat, however, this multiple of the human dose resulted in decreased pregnancies and in the retarded development of fetuses. These effects are thought to be due to an inhibition or delay in implantation which is also observed in rodents administered other antipsychotic drugs. In the rabbit, maternal toxicity, mortality, decreased weight gain, and embryotoxicity including increased resorptions were dose-related. Because animal reproduction studies are not always predictive of human response, pimozide should be given to a pregnant woman only if the potential benefits of treatment clearly outweigh the potential risks. Nonteratogenic Effects Neonates exposed to antipsychotic drugs, during the third trimester of pregnancy are at risk for extrapyramidal and/or withdrawal symptoms following delivery. There have been reports of agitation, hypertonia, hypotonia, tremor, somnolence, respiratory distress and feeding disorder in these neonates. These complications have varied in severity; while in some cases symptoms have been self-limited, in other cases neonates have required intensive care unit support and prolonged hospitalization. ORAP should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Taking Pimozide While Breastfeeding
What are recommendations for lactation if you're taking Pimozide?
Because there is no published experience with pimozide during breastfeeding, other drugs are preferred.
Maternal / infant drug levels
Because there is no published experience with pimozide during breastfeeding, other drugs are preferred.
Possible effects of Pimozide on milk supply
Pimozide can cause hyperprolactinemia.[1][2] The hyperprolactinemia is caused by the drug’s dopamine-blocking action in the tuberoinfundibular pathway.[3]
Possible alternatives to Pimozide
Haloperidol.
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Fiore L, Scapagnini U, Canonico PL. Effect of dihydroergocryptine and dihydroergocristine on cyclic AMP accumulation and prolactin release in vitro: evidence for a dopaminomimetic action. Horm Res. 1987;25:171-7. PMID: 3032757
2. Delitala G, Masala A, Alagna S. Suppression of pimozide-induced prolaction secretion by piridoxine (vitamin B6). Biomedicine. 1977;27:190-2.
3. Maguire GA. Prolactin elevation with antipsychotic medications: mechanisms of action and clinical consequences. J Clin Psychiatry. 2002;63(suppl 4):56-62. PMID: 11913677
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
