Sertindole

Introduced 1996

Reviewed by the HeyPsych Medical Review Board

Board-certified psychiatrists and mental health professionals

Indications

Primary Indications

Treatment of schizophrenia in adults

Mechanism

Antagonizes central dopamine D2 receptors and serotonin 5-HT2A receptors, reducing positive symptoms of schizophrenia; also blocks alpha-1 adrenergic receptors, which may contribute to orthostatic hypotension.

Dosing

Adult Dosing

oral: Initial: 4 mg once daily; increase in 4 mg increments at intervals of at least 4–5 days to a typical dose range of 12–20 mg/day; maximum 24 mg/day.

Dosage Forms

Tablets: 4 mg, 12 mg, 20 mg

Onset Duration

Antipsychotic effects may appear within 1–2 weeks, with full effects potentially requiring several weeks of continued therapy.

Adverse Effects

Common Side Effects

• rhinitis

• orthostatic hypotension

• dizziness

• weight gain

• dry mouth

⚠️ Serious Side Effects

QT interval prolongation
torsades de pointes
sudden cardiac death
neuroleptic malignant syndrome

Warnings

Critical Safety Information

→Associated with dose-dependent QT interval prolongation; use only if other antipsychotics are ineffective or not tolerated
→Contraindicated in patients with cardiac conduction abnormalities or electrolyte disturbances
→Monitor ECG at baseline, after dose increases, and periodically during treatment
→Use caution in hepatic impairment; avoid in severe cases

Interactions

With: QT-prolonging drugs (e.g., certain antiarrhythmics, macrolide antibiotics)

Risk: Additive QT prolongation

Action: Avoid combination

With: CYP3A4 inhibitors (e.g., ketoconazole, erythromycin)

Risk: Increased sertindole levels

Action: Avoid combination

With: CYP3A4 inducers (e.g., rifampin, carbamazepine)

Risk: Reduced sertindole levels

Action: Avoid combination

With: Antihypertensives

Risk: Additive hypotension

Action: Monitor blood pressure

Monitoring

Baseline and follow-up ECG
Electrolytes (potassium, magnesium)
Cardiac symptoms (palpitations, syncope)
Psychiatric status and treatment response

Special Populations

👶Pregnancy

Limited human data; use only if benefits outweigh risks; potential risk of neonatal extrapyramidal or withdrawal symptoms.

🤱Breastfeeding

Unknown if excreted in human milk; avoid breastfeeding or monitor infant for sedation or feeding difficulties.

👴Older Adults (65+)

Increased risk of orthostatic hypotension and cardiac effects; use lower initial doses and monitor closely.

Tapering

Gradually taper over 1–2 weeks to reduce risk of withdrawal or relapse.

Clinical Notes

Withdrawn from some markets due to cardiac safety concerns; available under restricted programs in others
Not considered first-line therapy for schizophrenia due to safety profile
Baseline and ongoing ECG monitoring is mandatory

This medication information is for educational purposes only and is not a substitute for professional medical advice. Always consult your healthcare provider before starting, stopping, or changing any medication. Never take medication without a prescription from a licensed healthcare provider.

Interested in this treatment?

This information is for educational purposes. Always consult with a qualified healthcare provider before starting any new treatment.

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Sertindole

Introduced 1996

Reviewed by the HeyPsych Medical Review Board

Board-certified psychiatrists and mental health professionals

Indications

Primary Indications

Treatment of schizophrenia in adults

Mechanism

Dosing

Adult Dosing

oral: Initial: 4 mg once daily; increase in 4 mg increments at intervals of at least 4–5 days to a typical dose range of 12–20 mg/day; maximum 24 mg/day.

Dosage Forms

Tablets: 4 mg, 12 mg, 20 mg

Onset Duration

Antipsychotic effects may appear within 1–2 weeks, with full effects potentially requiring several weeks of continued therapy.

Adverse Effects

Common Side Effects

• rhinitis

• orthostatic hypotension

• dizziness

• weight gain

• dry mouth

⚠️ Serious Side Effects

QT interval prolongation
torsades de pointes
sudden cardiac death
neuroleptic malignant syndrome

Warnings

Critical Safety Information

→Associated with dose-dependent QT interval prolongation; use only if other antipsychotics are ineffective or not tolerated
→Contraindicated in patients with cardiac conduction abnormalities or electrolyte disturbances
→Monitor ECG at baseline, after dose increases, and periodically during treatment
→Use caution in hepatic impairment; avoid in severe cases

Interactions

With: QT-prolonging drugs (e.g., certain antiarrhythmics, macrolide antibiotics)

Risk: Additive QT prolongation

Action: Avoid combination

With: CYP3A4 inhibitors (e.g., ketoconazole, erythromycin)

Risk: Increased sertindole levels

Action: Avoid combination

With: CYP3A4 inducers (e.g., rifampin, carbamazepine)

Risk: Reduced sertindole levels

Action: Avoid combination

With: Antihypertensives

Risk: Additive hypotension

Action: Monitor blood pressure

Monitoring

Baseline and follow-up ECG
Electrolytes (potassium, magnesium)
Cardiac symptoms (palpitations, syncope)
Psychiatric status and treatment response

Special Populations

👶Pregnancy

Limited human data; use only if benefits outweigh risks; potential risk of neonatal extrapyramidal or withdrawal symptoms.

🤱Breastfeeding

Unknown if excreted in human milk; avoid breastfeeding or monitor infant for sedation or feeding difficulties.

👴Older Adults (65+)

Increased risk of orthostatic hypotension and cardiac effects; use lower initial doses and monitor closely.

Tapering

Gradually taper over 1–2 weeks to reduce risk of withdrawal or relapse.

Clinical Notes

Withdrawn from some markets due to cardiac safety concerns; available under restricted programs in others
Not considered first-line therapy for schizophrenia due to safety profile
Baseline and ongoing ECG monitoring is mandatory

Interested in this treatment?

This information is for educational purposes. Always consult with a qualified healthcare provider before starting any new treatment.

Locate Psychiatrists