- OralClozapineClopine, Clozaril5-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.
- Less extrapyramidal adverse effects and less hyperprolactinaemia than first generation antipsychotics.
- Psychosis – schizophrenia, and related disorders
- Acute mania
- Maintenance therapy for bipolar I disorder (low-dose)
- Adverse Effects
- Postural hypotension
- Prolonged QTc
- Weight gain
- Anticholinergic – dry mouth, blurred vision, constipation, urinary retention, delirium
- Extrapyramidal – dystonia, akathisia, parkinsonism, tardive dyskinesia
- Hyperprolactinaemia – gynaecomastia, galactorrhoea, infertility, sexual dysfunction