Class- Tricylic dibenzodiazepine atypical antipsychotic
Indications
Administration/AbsorptionDosage
DistributionMechanism- Selective monoaminergic antagonist with high affinity for:
- serotonin Type 2 (5HT2)
- dopamine Type 2 (D2)
- Clozapine acts as an antagonist at other receptors, but with lower potency, explaining side effects
- Antagonism of histamine H1 receptors may explain somnolence
- Antagonism of adrenergic a1 receptors may explain orthostatic hypotension
- Antipsychotic action is likely mediated through a combination of antogistic effects at:
- D2 receptors in the mesolimbic pathway
- Relieves positive symptoms
- 5-HT2A receptors in the frontal cortex
- Alleviates negative symptoms.
Excretion- Half-life 8 hours (range 4-12 hours)
- Approximately 50% of the administered dose is excreted in the urine and 30% in the feces
Side effects- Serious
- agranulocytosis
- monitoring by frequent FBC
- seizures
- myocarditis
- other adverse cardiovascular and respiratory effects
- increased mortality in elderly patients with dementia-related psychosis
- Other
Interactions
- Fluvoxamine inhibits the metabolism of clozapine leading to significantly increased blood levels of clozapine
- Alcohol
- Caffeine
Contraindications
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