Perospirone ( Lullan) is an atypical antipsychotic of the azapirone family.
Medical uses
Its primary uses are in the treatment of schizophrenia and bipolar mania.
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Schizophrenia
In a clinical trial that compared it to haloperidol in the treatment of schizophrenia it was found to produce significantly superior overall symptom control.
A meta-analysis published in 2013 found that it is statistically significantly less efficacious than other second-generation antipsychotics.
Adverse effects
Has a higher incidence of extrapyramidal side effects than the other atypical antipsychotics, but still less than that seen with typical antipsychotics.[ It may produce less QT interval prolongation than zotepine, as in one patient who had previously been on zotepine switching to perospirone corrected their prolonged QT interval.][
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Discontinuation
The British National Formulary recommends a gradual withdrawal when discontinuing antipsychotics to avoid acute withdrawal syndrome or rapid relapse.[ Less commonly there may be a felling of the world spinning, numbness, or muscle pains.][ Symptoms generally resolve after a short period of time.][
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There is tentative evidence that discontinuation of antipsychotics can result in psychosis.
Rarely tardive dyskinesia can occur when the medication is stopped.[
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Pharmacology
Perospirone binds to the following receptors with very high affinity (as an antagonist unless otherwise specified):
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5-HT1A (partial agonist; Ki = 2.9 nM)
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5-HT2A (inverse agonist; Ki = 1.3 nM)
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D2 (Ki = 0.6 nM)
And the following receptor with high affinity:[
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And the following with moderate affinity:[
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And with low affinity for the following receptor:[
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See also
