ZOTEPINE (‘Zoleptil’)
Zot - a - peen
Why have I been prescribed zotepine?
Zotepine is used to help treat schizophrenia, psychosis and many other similar conditions.
When they have schizophrenia, many people hear voices talking to them or about them. They may also become suspicious
or paranoid. Some people also have problems with their thinking and feel that other people can read their thoughts. These
are called "positive symptoms". Zotepine can help to relieve these symptoms. Many people with schizophrenia also
experience "negative symptoms". They feel tired and lacking in energy and may become quite inactive and withdrawn.
Zotepine may help relieve these symptoms as well.
What exactly is zotepine?
Zotepine is an antipsychotic. Schizophrenia and similar disorders are sometimes referred to as psychoses, hence the
name given to this group of medicines, which is the “antipsychotics”. They are sometimes also called the neuroleptics or
(incorrectly) major tranquillisers. Zotepine has been around in the UK since 1999 and has been used in Japan for the last
20 years. The trade or brand name for zotepine is ‘Zoleptil’.
Is zotepine safe to take?
It is usually safe to have zotepine regularly as prescribed by your doctor, but it doesn’t suit everyone. Let your doctor know
if any of the following apply to you, as extra care may be needed:
a) if you have epilepsy (or a family history of epilepsy), diabetes, urinary retention, acute gout, Parkinson's disease or
glaucoma, or suffer from heart, liver, kidney, or prostate trouble;
b) if you are taking any other medication from any source;
c) if you are pregnant, breast feeding, or wish to become pregnant.
What is the usual dose of zotepine?
The starting dose of zotepine is 75mg a day. The dose can be increased every four days. The maximum dose of zotepine
is 300mg a day.
How should I take my zotepine?
Look at the label on your medicine; it should have all the necessary instructions on it. Follow this advice carefully. If you
have any questions, speak to your doctor or pharmacist. Most medicines are now dispensed with an information leaflet for
you to read.
What should I do if I miss a dose?
Never change your dose without checking with your doctor. If you forget a dose, take it as soon as you remember, as long
as it is within a few hours of the usual time.
What about alcohol?
It is officially recommended that people taking zotepine should not drink alcohol. This is because both zotepine and alcohol
can cause drowsiness. If the two are taken at the same time, severe drowsiness can result. This can lead to falls or
accidents. As well as this, drinking alcohol often makes psychosis worse. Excessive drinking is especially likely to do this.
Once people are used to taking medication, they can sometimes drink alcohol in small amounts without any harm. Avoid
alcohol altogether for the first one or two months. After this, if you want a drink, try a glass of your normal drink and see
how you feel. If this doesn’t make you feel drowsy, then it is probably OK to drink small amounts. It pays to be very cautious
because alcohol affects people in different ways, especially when they are taking medication.
Don't stop taking your medication because you fancy a drink. Discuss any concerns you may have with your doctor,
pharmacist or nurse. If you do drink alcohol, drink only small amounts. Never drink any alcohol and drive.
What will happen to me when I start taking zotepine?
Antipsychotics do not work straight away. For example, it may take several days or even weeks for some of the symptoms
to reduce. To begin with, most people find that this medication will help them feel more relaxed and calm. Later, after one
or two weeks, other symptoms should begin to improve.
Unfortunately, you might get some side effects before you start to feel any better. Most side effects should go away after a
few weeks. Look at the table over the page. It tells you what to do if you get any of the usual side effects. Not everyone will
get the side effects shown. There are many other possible side effects. Ask your pharmacist, doctor or nurse if you are
worried about anything else that you think might be a side effect.
Side effect What is it? What should I do if it happens to me?
COMMON
Dry mouth. Not much saliva or spit. Sugar-free boiled sweets, chewing gum or eating citrus fruits
usually helps. If not, your doctor can give you a mouth spray.
A change in medicine or dose may be possible.
Blurred vision Things look fuzzy and you can’t focus properly. See your
doctor if you are worried. You won’t need glasses.
Feeling "bunged up" inside. You can't pass a
motion or stool.
Eat more fibre e.g. bran, fruit and vegetables. Do more
walking. Make sure you drink plenty of fluid. A mild laxative
from a pharmacy might help.
ANTI-
CHOLINERGIC
EFFECTS
Difficulty in passing urine Contact your doctor now.
ANXIETY,
AGITATION
You feel more on edge. Try and relax by taking deep breaths. Wear loose clothing.
See your doctor if it is bad.
DROWSINESS Feeling sleepy or sluggish. It can last for a few
hours after taking your dose
Don’t drive or use machinery. Ask your doctor if you can take
your zotepine at different times.
HYPER -
SALIVATION
Your mouth gets full of saliva or spit. You may
drool – your pillow may be wet in the morning
If it annoys you, your doctor can give you a tablet for it. Some
people find propping up pillows at night helps a bit.
HYPOTENSION A low blood pressure. You may feel faint when
you stand up.
Try not to stand up too quickly. If you feel dizzy, don’t drive.
This dizziness is not dangerous
MOVEMENT
DISORDERS
Feeling shaky or having a tremor. Your neck
may twist back. Your eyes and tongue may
move on their own.
Tell your doctor about this. He/she may be able to do
something about it.
SWEATING You sweat more than usual. See your doctor if it is bad.
WEIGHT GAIN Eating more and putting on weight, especially
just after you start taking zotepine
Avoid fatty foods like chocolate, crisps and fizzy drinks. A diet
full of vegetables and fibre will usually help, as will physical
activities such as walking. If it becomes a problem or you are
worried, ask to see a dietician.
UNCOMMON
ALTERED
LIVER
FUNCTION
Your liver is not working as normal. You should
not feel any symptoms. This is only discovered if
your doctor does a blood test.
Continue to take your zotepine. Your doctor will probably want
to do regular blood tests to make sure your liver is O.K.
Serious liver problems don’t occur with zotepine, so don’t
worry too much.
AKATHISIA You feel restless, unable to feel comfortable
unless you are moving.
Tell your doctor about this. It may be possible to change your
drug or dose, or give you something to reduce these feelings.
NAUSEA AND
VOMITING
Feeling sick or being sick. Taking each dose with or after food may help. If it is bad,
contact your doctor.
RAISED
PROLACTIN
Prolactin is a natural chemical we all have. High
levels can affect periods in women or cause
impotence in men. It may also cause breast
tenderness and milk secretion, in men as well
as women.
This sometimes wears off in a few weeks, but discuss this with
your doctor anyway. It may be that a change in dose or
different drug will help.
SEIZURES Having fits Stop taking zotepine and contact your doctor now.
TACHYCARDIA This is a fast heart beat. It may feel like
palpitations
It is not usually dangerous. It can be easily treated if it lasts a
long time.
VERY RARE
NMS Neuroleptic Malignant Syndrome includes a high
body temperature, muscle stiffness and being
unable to move.
It usually occurs within a few weeks of a dose change. Contact
your doctor immediately. Keep cool, with fans or cool water.
When I feel better, can I stop taking zotepine?
No. If you stop taking zotepine, your original symptoms may return, but this may not be for 3 to 6 months after you stop the drug. You
and your doctor should decide together when you can come off it. Most people need to be on zotepine for quite a long time, sometimes
years. This is not thought to be harmful. Zotepine is not addictive.
Remember, leaflets like this can only describe some of the effects of medication. You may find other books or
leaflets also useful. If you have access to the internet you may find a lot of information there as well, but be
careful, as internet based information is not always accurate.
2001 United Kingdom Psychiatric Pharmacy Group www.ukppg.org.uk
This leaflet is to help you understand about your medicine. It is not an official manufacturer's Patient Information Leaflet. For more
information call the UKPPG National Telephone Helpline, 11am to 5pm, Monday to Friday on 020 7919 2999 or visit
www.nmhct.nhs.uk/pharmacy
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