A long-acting (depot) antipsychotic injection for schizophrenia

Pipotiazine

A long-acting antipsychotic given by injection to maintain treatment for schizophrenia.

What is Pipotiazine?

Pipotiazine is a long-acting antipsychotic, given as a 'depot' injection into a muscle every few weeks rather than as a daily tablet. It is used for the longer-term, maintenance treatment of schizophrenia, helping to keep symptoms under control. Because it is released slowly, it suits people who find regular tablets hard to keep up. Common effects include drowsiness, movement side effects such as stiffness or tremor, and reactions where the injection is given. It can also raise a hormone called prolactin. It is given and supervised by a healthcare team.

Class: Antipsychotic (long-acting depot injection) · Brands: Piportil Depot

Education and reference only. This is a plain-language guide to Pipotiazine — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.

Written by Meds Global Health Clinical Team · Clinically reviewed by Dr Muhammad Suffyan, MB BS, Founder & Clinical Director · Last reviewed · How we review
Class: Antipsychotic (long-acting depot injection) → Brands: Piportil Depot
Pipotiazine (Antipsychotic (long-acting depot injection)) — Meds Global Health reference card with 2D molecular structure
Pipotiazine — Antipsychotic (long-acting depot injection). The image shows the active ingredient's 2D molecular structure.

What it is

Pipotiazine is a long-acting antipsychotic of the phenothiazine type, used to maintain treatment for schizophrenia, a long-term mental-health condition that can cause hallucinations, delusions and disordered thinking. Rather than being taken as a daily tablet, it is given as a depot injection into a muscle, from which it is released slowly over several weeks. This makes it useful for people who would prefer not to, or find it hard to, take medicine every day. It is given by a healthcare professional, usually after an initial test dose, and the gaps between injections are set by the team.

How it works

Pipotiazine works mainly by blocking dopamine, a chemical messenger in the brain linked, when overactive, to symptoms such as delusions and hallucinations. By dampening this signalling, it helps keep these symptoms under control. Because it is formulated as a long-acting depot, a single injection releases the medicine slowly into the body over weeks, providing steady treatment without daily tablets. This steady release is the main advantage, but it also means that if side effects occur, they can take time to wear off because the medicine lingers.

Company & origin

Originated / developed by: Generic (long-established).

A long-acting phenothiazine antipsychotic given as a depot injection in the UK for maintenance treatment of schizophrenia.

What it treats

Conditions Pipotiazine is used for

Schizophrenia & psychosisA serious mental illness where a person loses some contact with reality — treated with ant…

Practical use

How to take Pipotiazine

General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.

  • Attend your appointments to have the injection into a muscle on the schedule your team sets.
  • Expect a small test dose first, so your team can check how you tolerate it before regular dosing.
  • Report any stiffness, tremor, restlessness, drowsiness or injection-site problems to your team.
  • Do not miss injections without telling your team, as gaps can let symptoms return.
  • Mention any other medicines you take, as some can add to drowsiness or other effects.

Weighing it up

Advantages & disadvantages of Pipotiazine

Advantages

  • Provides steady, long-term treatment for schizophrenia without daily tablets.
  • Helpful for people who find taking regular tablets difficult.
  • Given every few weeks by a healthcare professional, who can keep an eye on progress.

Disadvantages

  • Can cause movement side effects such as stiffness, tremor or restlessness.
  • Side effects may take time to settle because the medicine releases slowly.
  • Can cause drowsiness, weight changes, raised prolactin and reactions where the injection is given.

Practical use

Good to know

The main point with pipotiazine is that it is a depot, a slow-release injection, so it is about steady, ongoing treatment rather than quick changes. A small test dose is usually given first to check tolerance before regular injections begin. Common effects include drowsiness and movement side effects such as stiffness, tremor or restlessness, which should be reported, and reactions where the injection is given, such as soreness or a lump. Like other antipsychotics of this type, it can also raise a hormone called prolactin, leading to effects such as breast tenderness or changes in periods, and can cause weight changes. Because the medicine releases slowly, side effects may take a while to settle even after an injection is stopped, so the team reviews treatment regularly.

Who should not take it / use with caution

  • People who have had a serious allergic reaction to pipotiazine or related phenothiazines should not have it.
  • It is used with caution in the elderly and in people with heart disease, Parkinson's disease or certain other conditions.
  • It should only be given under the supervision of a healthcare team experienced in its use.

Monitoring

  • Reviewing how well symptoms are controlled and watching for movement side effects.
  • Checking weight, and blood tests including prolactin where appropriate.
  • Reviewing the injection schedule and any injection-site reactions over time.

Side effects

  • Drowsiness, and movement effects such as stiffness, tremor, restlessness or slowed movements.
  • Reactions where the injection is given, such as soreness, redness or a lump.
  • Weight changes, and hormone effects such as breast tenderness or changes in periods.
  • Rarely but seriously, a severe reaction with high fever and muscle stiffness, or heart-rhythm changes, which need urgent medical attention.

Key interactions

  • It can add to the drowsiness caused by alcohol, strong painkillers and other sedating medicines.
  • It can interact with medicines that affect the heart's rhythm, so tell your team what you take.
  • Some medicines for Parkinson's disease can work against it, so combinations are reviewed.

Available as: A long-acting (depot) injection given into a muscle.

Answers

Pipotiazine: frequently asked questions

What is pipotiazine used for?

It is a long-acting antipsychotic given by injection to maintain treatment for schizophrenia, helping to keep symptoms under control over the longer term.

Why is it given as an injection?

It is a depot, a slow-release injection given every few weeks, which provides steady treatment and suits people who find daily tablets hard to keep up.

Why is a test dose given first?

A small test dose lets your team check how you tolerate the medicine before regular injections begin, since the effect lasts a long time.

Can it cause movement problems?

Yes, like other antipsychotics of this type it can cause stiffness, tremor or restlessness; report these so your treatment can be reviewed.

What if I want to stop it?

Talk to your team rather than simply missing injections; because it releases slowly, treatment changes are planned and reviewed carefully.

The wider class

About Antipsychotic (long-acting depot injection)

Pipotiazine belongs to the antipsychotic (long-acting depot injection) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.

AntipsychoticsDrugs for psychosis, bipolar disorder and other conditions — balanced against movement and metabolic side-effects. QuetiapineAn atypical antipsychotic used in schizophrenia and bipolar disorder; can cause sedation, …OlanzapineAn effective atypical antipsychotic for schizophrenia and bipolar disorder, well known for…AripiprazoleAn atypical antipsychotic for schizophrenia and bipolar disorder that tends to be more wei…RisperidoneA widely used atypical antipsychotic for schizophrenia and bipolar disorder, available as …HaloperidolA long-established first-generation antipsychotic used for schizophrenia, agitation and ot…LurasidoneA second-generation antipsychotic used for schizophrenia, often chosen for its relatively …PaliperidoneA second-generation antipsychotic for schizophrenia, available as daily tablets or as a lo…SulpirideAn antipsychotic used to treat schizophrenia; it can raise prolactin and cause movement ef…AmisulprideA second-generation antipsychotic used for schizophrenia that can calm symptoms at higher …ChlorpromazineAn older 'first-generation' antipsychotic used to treat schizophrenia and other conditions…FlupentixolAn antipsychotic for schizophrenia that can be taken as tablets or given as a long-acting …TrifluoperazineA first-generation antipsychotic used in schizophrenia and other psychosis, and at lower a…LevomepromazineA sedating antipsychotic used in psychosis but, in UK practice, most often in palliative c…PericyazineA first-generation (older) antipsychotic used for schizophrenia and severe agitation.…ZuclopenthixolAn older antipsychotic for schizophrenia, available as tablets and as a long-acting depot …AsenapineA second-generation antipsychotic taken as a tablet that dissolves under the tongue, used …CariprazineA second-generation antipsychotic for schizophrenia with a long-lasting effect in the body…DroperidolA butyrophenone medicine used mainly to prevent and treat nausea and vomiting, especially …BenperidolAn antipsychotic occasionally used under specialist care to control deviant antisocial sex…LoxapineAn antipsychotic medicine; its inhaled form is used in hospital settings to calm sudden ag…PericiazineAn older phenothiazine antipsychotic, also used for severe anxiety or agitation, that is m…PimozideAn antipsychotic tablet used for schizophrenia and a specific delusional condition, which …PromazineAn older antipsychotic used mainly for short-term agitation and restlessness, especially i…FluphenazineAn older antipsychotic used for schizophrenia, often as a long-acting depot injection that…PerphenazineA first-generation antipsychotic used for conditions such as schizophrenia, and also to tr…ZiprasidoneA second-generation antipsychotic used for schizophrenia and bipolar disorder, taken with …BrexpiprazoleA newer antipsychotic used for schizophrenia and as an add-on in depression that has not r…IloperidoneA second-generation antipsychotic used to treat schizophrenia, with the dose built up slow…ThiothixeneA first-generation antipsychotic used to treat schizophrenia, more commonly seen as a Unit…Aripiprazole lauroxilA long-acting depot injection of the antipsychotic aripiprazole, given every few weeks to …LumateperoneA newer once-daily antipsychotic used for schizophrenia and for bipolar depression.…MolindoneAn older first-generation antipsychotic used to treat schizophrenia, mainly available in t…PimavanserinA medicine used to treat the hallucinations and delusions (psychosis) that can occur in Pa…ClozapineThe most effective medicine for schizophrenia that has not responded to other treatments —…

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Mental healthConditions and medicines for mood, anxiety, psychosis, sleep and dependence — used alongsi…

Authoritative sources

  • BNF
  • NICE CKS

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