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Brand: Orap
Published 2026-02-16 · Last reviewed 2026-02-23 · 4 references
Content sourced from FDA labeling (DailyMed) and peer-reviewed literature.
Pimozide is an antipsychotic-class dopamine receptor antagonist used primarily for tic suppression in Tourette’s disorder. The label states it is not intended as a first-choice treatment and is reserved for patients who have failed standard treatment and whose functioning is severely compromised by tics (label).
Cardiac safety is central: pimozide prolongs the QT interval and has extensive contraindicated drug interactions. Labeling calls for a baseline ECG and periodic ECG monitoring, especially during dose adjustment (label).
The AAN guideline summary for tic disorders emphasizes behavioral interventions and layered treatment selection; dopamine-blocking agents are typically reserved for more severe impairment or when other options are insufficient (Pringsheim 2019).
The pimozide compare view, evidence feed, and print page support interaction review and counseling.
Pimozide’s role is defined by two constraints: (1) it is reserved for clinically significant Tourette impairment after other options, and (2) its QT risk and interaction list require a careful medication review. Co-management with neurology is common (label/Pringsheim 2019).
View labelExactRefer to the Glossary entry on Neurotransmitters for background on receptor systems involved in serious mental illness.
Dopamine receptor antagonism is thought to underlie tic suppression (label).
Dopamine blockade also explains antipsychotic-class risks (EPS and tardive dyskinesia).