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Mozep (pimozide) is an antipsychotic medication predominantly used to treat Tourette's syndrome, though it does see some use in other conditions. It should not be used in patients under 12 years old.

Mozep is thought to work by inhibiting dopamine production in the brain. It is a potent medication that is typically used only when other medications don't work or are unsuitable for some reason, such as allergies. There are a range of side effects associated with Mozep, some of which can be quite severe, even life-threatening. Patients taking this medication are strongly encouraged to keep all doctor appointments and contact their doctor with any concerning side effects.

Mozep Uses

Though primarily used in Tourette's syndrome, Mozep does see other uses:

  • Tourette's syndrome
  • Schizophrenia
  • Chronic psychosis
  • Delusional disorder
  • Paranoid personality disorder
  • Delusional parasitosis

The medication is particularly good at alleviating motor and vocal tics in Tourette's syndrome and minimizing or eliminating delusions.

In Tourette's, Mozep should be used only when tics are so severe that they're causing major disruption to daily life; the medication is not meant to treat mild or simply embarrassing tics. The medication is unlikely to eliminate tics entirely, but should significantly reduce their frequency and severity.

If using Mozep to treat delusions it should also be used only in severe cases. Depending on the patient and the condition, delusions may be eliminated entirely or may simply be minimized; patients often still have delusions to some degree but are able to recognize them as delusions, which can make a tremendous difference.

In both cases since treatment is for severe cases the difference in quality of life is often substantial.

A certain percentage of patients, particularly those being treated for delusions, simply don't respond to Mozep treatment. If no significant difference is noticed after a few weeks of treatment a doctor should be consulted about alternative options.

Taking Mozep

Mozep is available only in tablets. Tablet strengths range from 1 mg, 2 mg, or 4 mg. Taking tablets with food is optional. Tablets are usually (but not always) taken once per day, right before bedtime.

Treatment is typically similar regardless of the condition being treated. Treatment should start with low doses, gradually increased if needed until an effective dose is found. This allows the body to adjust and cuts back on side effects.

In adults standard treatment consists of:

  • Start with 1 or 2 mg Mozep per day. This dose may be divided into two smaller doses taken morning and evening if a doctor advises.
  • Dosage may be increased, if needed, every other day up to 0.2 mg Mozep per kg of body weight.
  • Do not exceed 0.2 mg per kg of body weight or 10 mg per day, whichever is lower.

And in children age 12 to 18:

  • Start with 0.5 mg Mozep per kg of body weight per day, taken as a single dose before bed.
  • Dosage may be increased, if needed, every third day up to 0.2 mg Mozep per kg of body weight per day.
  • Do not exceed 0.2 mg per kg of body weight or 10 mg per day, whichever is lower.

Doctor instructions may vary and should always be followed. Treatment should periodically be reduced or stopped to see if continued treatment is necessary. However, reducing or stopping treatment can produce symptoms; it will take a week or two of reduced/stopped treatment before establishing that symptoms are from the condition and not from medication withdrawal.

Some improvements are typically seen within days of reaching an effective dose. If there is no noticeable improvement after several days or the condition worsens at any time speak with a doctor.

Potential Complications

Mozep is a potent medication that can produce serious adverse reactions. Patients should avoid Mozep use altogether if there is a history---including family history---of:

  • QT interval prolongation
  • Heart arrhythmia
  • Hypokalaemia (low blood potassium)
  • Hypomagnesaemia (low blood magnesium)

Mozep should also be avoided if taking certain medications:

  • Selective serotonin reuptake inhibitors (SSRIs)
  • CYP3A4, CYP1A2, or CYP2D6 inhibitors

Those for whom Mozep is considered suitable may still experience side effects, though fortunately not all are dangerous. Common side effects include:

  • Dry mouth
  • Dizziness
  • Constipation
  • Excessive sleepiness
  • Increased nighttime urination
  • Excessive sweating
  • Difficulty speaking

The above often stop occurring as the body adjusts to treatment. If they do not---or if they become severe enough to be disruptive---a doctor should be consulted; treatment may end, at which point side effects should reverse.

Major side effects are more rare but also more dangerous. These are dose-dependent to some degree; they're more likely to occur at higher doses, though there are exceptions. Side effects which warrant medical attention include:

  • Low blood pressure
  • Decreased number of blood cells
  • QT interval prolongation
  • Heart arrhythmia
  • Severe sedation
  • Extrapyramidal symptoms (involuntary body movements)

Some of the above can be difficult to detect without the aid of a doctor; regular checkups are highly advisable for this reason. Untreated the above can lead to a significant loss of quality of life, and some may lead to death. Stopping treatment usually reverses symptoms.

Other medications can also interfere with Mozep. Unlike those listed above Mozep use is not contraindicated with these medications but the prescribing doctor should be aware they're being taken and may modify dosage of Mozep, the other medications, or both:

  • Macrolide antibiotics
  • Antidepressant medications
  • Other antipsychotic medications
  • Antifungal medications
  • HIV or AIDS medications
  • Zileuton (usually used for asthma)

There may be additional potentially-harmful medications as well. Always double-check with a doctor before taking other medications with Mozep, including over-the-counter varieties.

Orap/Mozep

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Medicines have benefits and some have risks. Always read the label and use only as directed. If symptoms persist or you have side effects see your health professional.

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