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Clozapine

 
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  •  
    Oral
    Clozapine
    Clopine, Clozaril 
     
    5-HT2A and D4 receptor blocker, with weak D2 receptor antagonism
    Used for treatment-resistant schizophrenia

    Causes myocarditis / myopathy, agranulocytosis

  • Mechanism of Action

  • Seems to cause transient antagonism of D2 receptors, as well as serotonin 5-HT2A antagonism.

  • Pharmacology

  • Less extrapyramidal adverse effects and less hyperprolactinaemia than first generation antipsychotics.

Clinical Use

  • Indications
  • Psychosis - schizophrenia, and related disorders
  • Acute mania
  • Maintenance therapy for bipolar I disorder (low-dose)
  • Adverse Effects
  • Drowsiness
  • Postural hypotension
  • Prolonged QTc
  • Dyslipidaemia
  • Weight gain
  • Anticholinergic - dry mouth, blurred vision, constipation, urinary retention, delirium
  • Extrapyramidal - dystonia, akathisia, parkinsonism, tardive dyskinesia
  • Hyperprolactinaemia - gynaecomastia, galactorrhoea, infertility, sexual dysfunction
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