Impromen (Bromperidol)

Impromen, a typical antipsychotic of the butyrophenone class, is used to treat disorders that involve dopaminergic overactivity.

• Schizophrenia: helps reduce positive symptoms such as hallucinations, delusions, and thought disorder, facilitating stabilization of chronic illness.
• Acute psychotic episodes: provides rapid control of severe agitation, psychosis, and behavioral disturbances, allowing safe management in emergency or inpatient settings.

• Bromperidol exerts its therapeutic effect primarily by antagonizing dopamine D2 receptors in the mesolimbic and mesocortical pathways, thereby decreasing dopaminergic neurotransmission that underlies psychotic symptoms. It also exhibits moderate affinity for serotonin 5‑HT2 receptors, contributing to its overall antipsychotic profile without significant partial agonist activity.

Bromperidol may cause a range of adverse reactions that vary in frequency and severity.

Common Side Effects

• Extrapyramidal symptoms: muscle rigidity, tremor, or akathisia.
• Sedation or drowsiness.
• Dry mouth and constipation.
• Dizziness or orthostatic hypotension.

Serious or Rare Side Effects

• Neuroleptic malignant syndrome: fever, rigidity, autonomic instability.
• Tardive dyskinesia: persistent involuntary movements.
• Agranulocytosis: severe reduction in white blood cells.

Before initiating bromperidol therapy, clinicians should assess patient‑specific risk factors and monitor for potential complications.

• Extrapyramidal monitoring: observe for early signs of movement disorders and adjust therapy as needed.
• Cardiovascular assessment: evaluate baseline ECG and blood pressure, especially in patients with cardiac disease.
• Hepatic function: check liver enzymes periodically in patients with hepatic impairment.
• Elderly caution: start at the lowest effective dose and monitor for sedation or falls.
• Discontinuation: avoid abrupt cessation to reduce risk of rebound psychosis.
• Store at ambient temperature: keep in original packaging, protect from moisture and direct sunlight.

Bromperidol can interact with other medications, altering efficacy or safety.

Major Interactions (Avoid)

• CNS depressants (e.g., benzodiazepines, opioids): may enhance sedation and respiratory depression.
• Antihypertensives: additive hypotensive effect.
• QT‑prolonging agents (e.g., certain antiarrhythmics, macrolide antibiotics): increase risk of cardiac arrhythmias.

Moderate Interactions (Monitor Closely)

• Anticholinergic drugs: may mask extrapyramidal symptoms.
• CYP2D6 inhibitors (e.g., fluoxetine, paroxetine): can raise bromperidol plasma levels, requiring dose adjustment.