A tricylic dibenzodiazepine, classified as an atypical antipsychotic agent. It binds several types of central nervous system receptors, and displays a unique pharmacological profile. Clozapine is a serotonin antagonist, with strong binding to 5-HT 2A/2C receptor subtype. It also displays strong affinity to several dopaminergic receptors, but shows only weak antagonism at the dopamine D2 receptor, a receptor commonly thought to modulate neuroleptic activity. Agranulocytosis is a major adverse effect associated with administration of this agent.
Agents that control agitated psychotic behavior, alleviate acute psychotic states, reduce psychotic symptoms, and exert a quieting effect. They are used in SCHIZOPHRENIA; senile dementia; transient psychosis following surgery; or MYOCARDIAL INFARCTION; etc. These drugs are often referred to as neuroleptics alluding to the tendency to produce neurological side effects, but not all antipsychotics are likely to produce such effects. Many of these drugs may also be effective against nausea, emesis, and pruritus.
A phenyl-piperidinyl-butyrophenone that is used primarily to treat SCHIZOPHRENIA and other PSYCHOSES. It is also used in schizoaffective disorder, DELUSIONAL DISORDERS, ballism, and TOURETTE SYNDROME (a drug of choice) and occasionally as adjunctive therapy in INTELLECTUAL DISABILITY and the chorea of HUNTINGTON DISEASE. It is a potent antiemetic and is used in the treatment of intractable HICCUPS. (From AMA Drug Evaluations Annual, 1994, p279)
A severe emotional disorder of psychotic depth characteristically marked by a retreat from reality with delusion formation, HALLUCINATIONS, emotional disharmony, and regressive behavior.
A selective blocker of DOPAMINE D2 RECEPTORS and SEROTONIN 5-HT2 RECEPTORS that acts as an atypical antipsychotic agent. It has been shown to improve both positive and negative symptoms in the treatment of SCHIZOPHRENIA.
A group of two-ring heterocyclic compounds consisting of a benzene ring fused to a diazepine ring.
Dibenzothiazepines are a class of heterocyclic chemical compounds that contain a dibenzothiazepine ring structure, which have been used in the development of various pharmaceutical drugs, particularly as tranquilizers, muscle relaxants, and anticonvulsants, but their use has declined due to side effects and the development of newer drugs.
An antimuscarinic agent that inhibits gastric secretion at lower doses than are required to affect gastrointestinal motility, salivary, central nervous system, cardiovascular, ocular, and urinary function. It promotes the healing of duodenal ulcers and due to its cytoprotective action is beneficial in the prevention of duodenal ulcer recurrence. It also potentiates the effect of other antiulcer agents such as CIMETIDINE and RANITIDINE. It is generally well tolerated by patients.
Psychotic organic mental disorders resulting from the toxic effect of drugs and chemicals or other harmful substance.
A condition characterized by inactivity, decreased responsiveness to stimuli, and a tendency to maintain an immobile posture. The limbs tend to remain in whatever position they are placed (waxy flexibility). Catalepsy may be associated with PSYCHOTIC DISORDERS (e.g., SCHIZOPHRENIA, CATATONIC), nervous system drug toxicity, and other conditions.
Drugs that bind to but do not activate DOPAMINE RECEPTORS, thereby blocking the actions of dopamine or exogenous agonists. Many drugs used in the treatment of psychotic disorders (ANTIPSYCHOTIC AGENTS) are dopamine antagonists, although their therapeutic effects may be due to long-term adjustments of the brain rather than to the acute effects of blocking dopamine receptors. Dopamine antagonists have been used for several other clinical purposes including as ANTIEMETICS, in the treatment of Tourette syndrome, and for hiccup. Dopamine receptor blockade is associated with NEUROLEPTIC MALIGNANT SYNDROME.
A hallucinogen formerly used as a veterinary anesthetic, and briefly as a general anesthetic for humans. Phencyclidine is similar to KETAMINE in structure and in many of its effects. Like ketamine, it can produce a dissociative state. It exerts its pharmacological action through inhibition of NMDA receptors (RECEPTORS, N-METHYL-D-ASPARTATE). As a drug of abuse, it is known as PCP and Angel Dust.
Drugs that bind to but do not activate serotonin receptors, thereby blocking the actions of serotonin or SEROTONIN RECEPTOR AGONISTS.
A subfamily of G-PROTEIN-COUPLED RECEPTORS that bind the neurotransmitter DOPAMINE and modulate its effects. D2-class receptor genes contain INTRONS, and the receptors inhibit ADENYLYL CYCLASES.
Compounds with two BENZENE rings fused to AZEPINES.
Diseases of the BASAL GANGLIA including the PUTAMEN; GLOBUS PALLIDUS; claustrum; AMYGDALA; and CAUDATE NUCLEUS. DYSKINESIAS (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include CEREBROVASCULAR DISORDERS; NEURODEGENERATIVE DISEASES; and CRANIOCEREBRAL TRAUMA.
A serotonin receptor subtype found widely distributed in peripheral tissues where it mediates the contractile responses of variety of tissues that contain SMOOTH MUSCLE. Selective 5-HT2A receptor antagonists include KETANSERIN. The 5-HT2A subtype is also located in BASAL GANGLIA and CEREBRAL CORTEX of the BRAIN where it mediates the effects of HALLUCINOGENS such as LSD.
Cell-surface proteins that bind dopamine with high affinity and trigger intracellular changes influencing the behavior of cells.
Drugs that bind to but do not activate SEROTONIN 5-HT2 RECEPTORS, thereby blocking the actions of SEROTONIN or SEROTONIN 5-HT2 RECEPTOR AGONISTS. Included under this heading are antagonists for one or more specific 5-HT2 receptor subtypes.
A complex involuntary response to an unexpected strong stimulus usually auditory in nature.
Cell-surface proteins that bind SEROTONIN and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action.
An antipsychotic agent used in SCHIZOPHRENIA.
A decrease in the number of GRANULOCYTES; (BASOPHILS; EOSINOPHILS; and NEUTROPHILS).
A derivative of morphine that is a dopamine D2 agonist. It is a powerful emetic and has been used for that effect in acute poisoning. It has also been used in the diagnosis and treatment of parkinsonism, but its adverse effects limit its use.
A subtype of dopamine D2 receptors that has high affinity for the antipsychotic CLOZAPINE.
Study of mental processes and behavior of schizophrenics.

S-16924 [(R)-2-[1-[2-(2,3-dihydro-benzo[1,4]dioxin-5-yloxy)-ethyl]- pyrrolidin-3yl]-1-(4-fluorophenyl)-ethanone], a novel, potential antipsychotic with marked serotonin1A agonist properties: III. Anxiolytic actions in comparison with clozapine and haloperidol. (1/592)

S-16924 is a potential antipsychotic that displays agonist and antagonist properties at serotonin (5-HT)1A and 5-HT2A/2C receptors, respectively. In a pigeon conflict procedure, the benzodiazepine clorazepate (CLZ) increased punished responses, an action mimicked by S-16924, whereas the atypical antipsychotic clozapine and the neuroleptic haloperidol were inactive. Similarly, in a Vogel conflict paradigm in rats, CLZ increased punished responses, an action shared by S-16924 but not by clozapine or haloperidol. This action of S-16924 was abolished by the 5-HT1A antagonist WAY-100,635. Ultrasonic vocalizations in rats were inhibited by CLZ, S-16924, clozapine, and haloperidol. However, although WAY-100,635 abolished the action of S-16924, it did not affect clozapine and haloperidol. In a rat elevated plus-maze, CLZ, but not S-16924, clozapine, and haloperidol, increased open-arm entries. Like CLZ, S-16924 increased social interaction in rats, whereas clozapine and haloperidol were inactive. WAY-100,635 abolished this action of S-16924. CLZ, S-16924, clozapine, and haloperidol decreased aggressive interactions in isolated mice, but this effect of S-16924 was not blocked by WAY-100, 635. All drugs inhibited motor behavior, but the separation to anxiolytic doses was more pronounced for S-16924 than for CLZ. Finally, in freely moving rats, CLZ and S-16924, but not clozapine and haloperidol, decreased dialysis levels of 5-HT in the nucleus accumbens: this action of S-16924 was blocked by WAY-100,165. In conclusion, in contrast to haloperidol and clozapine, S-16924 possessed a broad-based profile of anxiolytic activity at doses lower than those provoking motor disruption. Its principal mechanism of action was activation of 5-HT1A (auto)receptors.  (+info)

Effect of psychotropic drugs on caudate spindle in cats. (2/592)

To ascertain whether neuroleptics act on the caudate nucleus itself, the effects of these compounds as well as other centrally acting drugs were examined in relation to caudate spindle and EEG arousal responses (sciatic nerve stimulation) in gallamine-immobilized cats. Haloperidol and chlorpromazine enhanced the caudate spindle at a dose which had no effect on the EEG arousal response. On the other hand, clozapine and a higher dose of chlorpromazine enhanced the caudate spindle, but depressed the arousal response. High frequency stimulation of the sciatic nerve suppressed the caudate spindle. Pentobarbital, biperiden and diazepam, while depressing the arousal response, caused an enhancement of the caudate spindle. Imipramine at a low dose had no effect on either response, whereas at a high dose this drug enhanced the caudate spindle with concomitant depression of the arousal response. From these results, it may be concluded that the enhancing action on the caudate spindle induced by haloperidol and a low dose of chlorpromazine is due to an increase in susceptibility of the caudate nucleus itself. In addition, it is suggested that depression of the activating system is involved in an appearance of the caudate spindle.  (+info)

Mixed agonist-antagonist properties of clozapine at different human cloned muscarinic receptor subtypes expressed in Chinese hamster ovary cells. (3/592)

We recently reported that clozapine behaves as a partial agonist at the cloned human m4 muscarinic receptor subtype. In the present study, we investigated whether the drug could elicit similar effects at the cloned human m1, m2, and m3 muscarinic receptor subtypes expressed in the Chinese hamster ovary (CHO) cells. Clozapine elicited a concentration-dependent stimulation of [3H]inositol phosphates accumulation in CHO cells expressing either the m1 or the m3 receptor subtype. Moreover, clozapine inhibited forskolin-stimulated cyclic AMP accumulation and enhanced [35S] GTP gamma S binding to membrane G proteins in CHO cells expressing the m2 receptor. These agonist effects of clozapine were antagonized by atropine. The intrinsic activity of clozapine was lower than that of the full cholinergic agonist carbachol, and, when the compounds were combined, clozapine potently reduced the receptor responses to carbachol. These data indicate that clozapine behaves as a partial agonist at different muscarinic receptor subtypes and may provide new hints for understanding the receptor mechanisms underlying the antipsychotic efficacy of the drug.  (+info)

Low-dose clozapine for the treatment of drug-induced psychosis in Parkinson's disease. The Parkinson Study Group. (4/592)

BACKGROUND: Drug-induced psychosis is a difficult problem to manage in patients with Parkinson's disease. Multiple open-label studies have reported that treatment with clozapine at low doses ameliorates psychosis without worsening parkinsonism. METHODS: We conducted a randomized, double-blind, placebo-controlled trial of low doses of clozapine (6.25 to 50 mg per day) in 60 patients at six sites over a period of 14 months. The patients (mean age, 72 years) had idiopathic Parkinson's disease and drug-induced psychosis of at least four weeks' duration. All the patients continued to receive fixed doses of antiparkinsonian drugs during the four weeks of the trial. Blood counts were monitored weekly in all the patients. RESULTS: The mean dose of clozapine was 24.7 mg per day. The patients in the clozapine group had significantly more improvement than those in the placebo group in all three of the measures used to determine the severity of psychosis. The mean (+/-SE) scores on the Clinical Global Impression Scale improved by 1.6+/-0.3 points for the patients receiving clozapine, as compared with 0.5+/-0.2 point for those receiving placebo (P<0.001). The score on the Brief Psychiatric Rating Scale improved by 9.3+/-1.5 points for the patients receiving clozapine, as compared with 2.6+/-1.3 points for those receiving placebo (P=0.002). The score on the Scale for the Assessment of Positive Symptoms improved by 11.8+/-2.0 points for the patients receiving clozapine, as compared with 3.8+/-1.9 points for those receiving placebo (P=0.01). Seven patients treated with clozapine had an improvement of at least three on the seven-point Clinical Global Impression Scale, as compared with only one patient given placebo. Clozapine treatment improved tremor and had no deleterious effect on the severity of parkinsonism. In one patient, clozapine was discontinued because of leukopenia. CONCLUSIONS: Clozapine, at daily doses of 50 mg or less, is safe and significantly improves drug-induced psychosis without worsening parkinsonism.  (+info)

S-16924, a novel, potential antipsychotic with marked serotonin1A agonist properties. IV. A drug discrimination comparison with clozapine. (5/592)

The novel benzodioxopyrrolidine (S-16924) displays a clozapine-like profile of interaction with multiple monoaminergic receptors, in addition to potent agonist activity at serotonin (5-HT)1A receptors. S-16924 (2.5 mg/kg i.p.) and clozapine (5.0 mg/kg i.p.) generated robust discriminative stimuli (DS) and displayed full mutual generalization. The D4 antagonists L-745,870 and S-18126, the D1/D5 antagonist SCH-39166, and the D3 antagonist S-14297 showed at most partial generalization to S-16924 and clozapine. The D2/D3 antagonist raclopride fully generalized to S-16924, but only partially generalized to clozapine. The 5-HT2A antagonist MDL-100, 907 fully generalized to S-16924 and two further 5-HT2A antagonists, fananserin and SR-46349, showed partial generalization. However, MDL-100,907, fananserin, and SR-46349 showed less pronounced generalization to clozapine. Similarly, the 5-HT2C antagonists SB-200,646 and SB-206,553 more markedly generalized to S-16924 than to clozapine. The 5-HT1A receptor agonist (+/-)-8-dihydroxy-2-(di-n-propylamino) tetralin generalized fully to S-16924 but not to clozapine. Full generalization was obtained to both S-16924 and clozapine for the clozapine congeners, olanzapine and quetiapine. In distinction, the benzisoxazole, risperidone, and the phenylindole, sertindole, weakly generalized to S-16924 and clozapine. However, the benzisoxazole ziprasidone, which possesses 5-HT1A agonist properties, generalized fully to S-16924 but not to clozapine. Finally, the muscarinic antagonist scopolamine generalized fully to clozapine and partially to S-16924. In conclusion, S-16924 and clozapine display both communalities and differences in their "compound" DS; this likely reflects their respective complex patterns of interaction with multiple monoaminergic receptors. Although no specific receptor was identified as underlying the clozapine DS, 5-HT1A agonist as well as D2 and 5-HT2A/2C antagonist properties contribute to the S-16924 DS.  (+info)

Effects of atypical antipsychotic drug treatment on amphetamine-induced striatal dopamine release in patients with psychotic disorders. (6/592)

Clozapine, risperidone, and other new "atypical" antipsychotic agents are distinguished from traditional neuroleptic drugs by having clinical efficacy with either no or low levels of extrapyramidal symptoms (EPS). Preclinical models have focused on striatal dopamine systems to account for their atypical profile. In this study, we examined the effects of clozapine and risperidone on amphetamine-induced striatal dopamine release in patients with psychotic disorders. A novel 11C-raclopride/PET paradigm was used to derive estimates of amphetamine-induced changes in striatal synaptic dopamine concentrations and patients were scanned while antipsychotic drug-free and during chronic treatment with either clozapine or risperidone. We found that amphetamine produced significant reductions in striatal 11C-raclopride binding during the drug-free and antipsychotic drug treatment phases of the study which reflects enhanced dopamine release in both conditions. There were no significant differences in % 11C-raclopride changes between the two conditions indicating that these atypical agents do not effect amphetamine-related striatal dopamine release. The implications for these data for antipsychotic drug action are discussed.  (+info)

A cost-effectiveness clinical decision analysis model for schizophrenia. (7/592)

A model was developed to estimate the medical costs and effectiveness outcomes of three antipsychotic treatments (olanzapine, haloperidol, and risperidone) for patients with schizophrenia. A decision analytic Markov model was used to determine the cost-effectiveness of treatments and outcomes that patients treated for schizophrenia may experience over a 5-year period. Model parameter estimates were based on clinical trial data, published medical literature, and, when needed, clinician judgment. Direct medical costs were incorporated into the model, and outcomes were expressed by using three effectiveness indicators: the Brief Psychiatric Rating Scale, quality-adjusted life years, and lack of relapse. Over a 5-year period, patients on olanzapine had an additional 6.8 months in a disability-free health state based on Brief Psychiatric Rating Scale scores and more than 2 additional months in a disability-free health state based on quality-adjusted life years, and they experienced 13% fewer relapses compared with patients on haloperidol. The estimated 5-year medical cost associated with olanzapine therapy was $1,539 less than that for haloperidol therapy. Compared with risperidone therapy, olanzapine therapy cost $1,875 less over a 5-year period. Patients on olanzapine had approximately 1.6 weeks more time in a disability-free health state (based on Brief Psychiatric Rating Scale scores) and 2% fewer relapses compared with patients on risperidone. Sensitivity analyses indicated the model was sensitive to changes in drug costs and shortened hospital stay. Compared with both haloperidol and risperidone therapy, olanzapine therapy was less expensive and provided superior effectiveness outcomes even with conservative values for key parameters such as relapse and discontinuation rates.  (+info)

Looking beyond the formulary budget in cost-benefit analysis. (8/592)

With the introduction of newer, more expensive psychotropic medications, healthcare providers and managed care administrators must consider whether these drugs offer "value for the money." A true picture of the benefits of these drugs emerges only when all the costs of treatment are considered. Focusing exclusively on the acquisition cost of the drug can result in a misleading impression of the drug's worth. Although the medication costs associated with treating a patient with a newer drug increase, use of these agents may actually result in an overall decrease in healthcare costs, through reductions in hospitalization and length of stay, use of mental health services, and prescriptions for adjunctive drugs. In one study of the newer antipsychotic agent risperidone, the overall annual costs of treating a patient with schizophrenia were reduced by nearly $8,000 (Canadian dollars), even though medication costs increased by approximately $1,200 (Canadian dollars). Retrospective and prospective pharmacoeconomic studies can provide valuable data on the cost effectiveness of treatment with newer psychotropic medications.  (+info)

Clozapine is an atypical antipsychotic medication that is primarily used to treat schizophrenia in patients who have not responded to other antipsychotic treatments. It is also used off-label for the treatment of severe aggression, suicidal ideation, and self-injurious behavior in individuals with developmental disorders.

Clozapine works by blocking dopamine receptors in the brain, particularly the D4 receptor, which is thought to be involved in the development of schizophrenia. It also has a strong affinity for serotonin receptors, which contributes to its unique therapeutic profile.

Clozapine is considered a medication of last resort due to its potential side effects, which can include agranulocytosis (a severe decrease in white blood cell count), myocarditis (inflammation of the heart muscle), seizures, orthostatic hypotension (low blood pressure upon standing), and weight gain. Because of these risks, patients taking clozapine must undergo regular monitoring of their blood counts and other vital signs.

Despite its potential side effects, clozapine is often effective in treating treatment-resistant schizophrenia and has been shown to reduce the risk of suicide in some patients. It is available in tablet and orally disintegrating tablet formulations.

Antipsychotic agents are a class of medications used to manage and treat psychosis, which includes symptoms such as delusions, hallucinations, paranoia, disordered thought processes, and agitated behavior. These drugs work by blocking the action of dopamine, a neurotransmitter in the brain that is believed to play a role in the development of psychotic symptoms. Antipsychotics can be broadly divided into two categories: first-generation antipsychotics (also known as typical antipsychotics) and second-generation antipsychotics (also known as atypical antipsychotics).

First-generation antipsychotics, such as chlorpromazine, haloperidol, and fluphenazine, were developed in the 1950s and have been widely used for several decades. They are generally effective in reducing positive symptoms of psychosis (such as hallucinations and delusions) but can cause significant side effects, including extrapyramidal symptoms (EPS), such as rigidity, tremors, and involuntary movements, as well as weight gain, sedation, and orthostatic hypotension.

Second-generation antipsychotics, such as clozapine, risperidone, olanzapine, quetiapine, and aripiprazole, were developed more recently and are considered to have a more favorable side effect profile than first-generation antipsychotics. They are generally effective in reducing both positive and negative symptoms of psychosis (such as apathy, anhedonia, and social withdrawal) and cause fewer EPS. However, they can still cause significant weight gain, metabolic disturbances, and sedation.

Antipsychotic agents are used to treat various psychiatric disorders, including schizophrenia, bipolar disorder, major depressive disorder with psychotic features, delusional disorder, and other conditions that involve psychosis or agitation. They can be administered orally, intramuscularly, or via long-acting injectable formulations. The choice of antipsychotic agent depends on the individual patient's needs, preferences, and response to treatment, as well as the potential for side effects. Regular monitoring of patients taking antipsychotics is essential to ensure their safety and effectiveness.

Haloperidol is an antipsychotic medication, which is primarily used to treat schizophrenia and symptoms of psychosis, such as delusions, hallucinations, paranoia, or disordered thought. It may also be used to manage Tourette's disorder, tics, agitation, aggression, and hyperactivity in children with developmental disorders.

Haloperidol works by blocking the action of dopamine, a neurotransmitter in the brain, which helps to regulate mood and behavior. It is available in various forms, including tablets, liquid, and injectable solutions. The medication can cause side effects such as drowsiness, restlessness, muscle stiffness, and uncontrolled movements. In rare cases, it may also lead to more serious neurological side effects.

As with any medication, haloperidol should be taken under the supervision of a healthcare provider, who will consider the individual's medical history, current medications, and other factors before prescribing it.

Schizophrenia is a severe mental disorder characterized by disturbances in thought, perception, emotion, and behavior. It often includes hallucinations (usually hearing voices), delusions, paranoia, and disorganized speech and behavior. The onset of symptoms typically occurs in late adolescence or early adulthood. Schizophrenia is a complex, chronic condition that requires ongoing treatment and management. It significantly impairs social and occupational functioning, and it's often associated with reduced life expectancy due to comorbid medical conditions. The exact causes of schizophrenia are not fully understood, but research suggests that genetic, environmental, and neurodevelopmental factors play a role in its development.

Risperidone is an atypical antipsychotic medication that is primarily used to treat certain mental/mood disorders (such as schizophrenia, bipolar disorder, and irritability associated with autistic disorder). It works by helping to restore the balance of certain natural substances in the brain. Risperidone belongs to a class of drugs called benzisoxazole derivatives.

This medication can decrease aggression and schizophrenic symptoms such as hallucinations, delusional thinking, and hostility. It may also help to improve your mood, thoughts, and behavior. Some forms of risperidone are also used for the treatment of irritability in children and adolescents with autistic disorder (a developmental disorder that affects communication and behavior).

It's important to note that this is a general medical definition, and the use of risperidone should always be under the supervision of a healthcare professional, as it can have potential side effects and risks.

Benzodiazepines are a class of psychoactive drugs that have been widely used for their sedative, hypnotic, anxiolytic, anticonvulsant, and muscle relaxant properties. They act by enhancing the inhibitory effects of gamma-aminobutyric acid (GABA), the major inhibitory neurotransmitter in the central nervous system.

Benzodiazepines are commonly prescribed for the treatment of anxiety disorders, insomnia, seizures, and muscle spasms. They can also be used as premedication before medical procedures to produce sedation, amnesia, and anxiolysis. Some examples of benzodiazepines include diazepam (Valium), alprazolam (Xanax), clonazepam (Klonopin), lorazepam (Ativan), and temazepam (Restoril).

While benzodiazepines are effective in treating various medical conditions, they can also cause physical dependence and withdrawal symptoms. Long-term use of benzodiazepines can lead to tolerance, meaning that higher doses are needed to achieve the same effect. Abrupt discontinuation of benzodiazepines can result in severe withdrawal symptoms, including seizures, hallucinations, and anxiety. Therefore, it is important to taper off benzodiazepines gradually under medical supervision.

Benzodiazepines are classified as Schedule IV controlled substances in the United States due to their potential for abuse and dependence. It is essential to use them only as directed by a healthcare provider and to be aware of their potential risks and benefits.

Dibenzothiazepines are a class of heterocyclic chemical compounds that contain a dibenzothiazepine ring structure. This structure is composed of a benzene ring fused to a thiazepine ring, which is itself formed by the fusion of a benzene ring and a diazepine ring (a seven-membered ring containing two nitrogen atoms).

In the medical field, dibenzothiazepines are known for their pharmacological properties and have been used in the development of various drugs. Some dibenzothiazepine derivatives exhibit antipsychotic, anxiolytic, and anticonvulsant activities. However, due to their potential for adverse effects and the availability of safer alternatives, they are not widely used in clinical practice today.

It is important to note that specific dibenzothiazepine compounds may have unique properties and uses beyond their general classification as a chemical class. Always consult medical literature or healthcare professionals for accurate information on specific drugs or compounds.

Pirenzepine is a medication that belongs to a class of drugs called anticholinergics or parasympatholytics. It works by blocking the action of acetylcholine, a neurotransmitter in the body, on certain types of muscarinic receptors.

Pirenzepine is primarily used to treat peptic ulcers and gastroesophageal reflux disease (GERD) by reducing the production of stomach acid. It may also be used to manage symptoms of irritable bowel syndrome, such as abdominal pain and diarrhea.

The medication is available in the form of tablets or gel for topical application. Side effects of pirenzepine may include dry mouth, blurred vision, constipation, dizziness, and difficulty urinating. It should be used with caution in people with glaucoma, benign prostatic hyperplasia, or other conditions that may be exacerbated by anticholinergic drugs.

It is important to note that this definition is for informational purposes only and should not be taken as medical advice. Always consult with a healthcare professional before starting any new medication.

Substance-induced psychosis is a type of psychosis that is caused by the use of drugs, alcohol, or other substances. The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines substance/medication-induced psychotic disorder as follows:

A. Presence of one (or more) of the following symptoms:

1. Delusions.
2. Hallucinations.
3. Disorganized speech (e.g., frequent derailment or incoherence).

B. There is evidence from the history, physical examination, or laboratory findings that the disturbance is caused by the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a combination of substances.

C. The disturbance does not occur exclusively during the course of a delirium and is not better explained by a psychotic disorder that is not substance/medication-induced. The symptoms in Criterion A developed during or soon after substance intoxication or withdrawal, or after exposure to a medication.

D. The disturbance causes significant distress or impairment in social, occupational, or other important areas of functioning.

E. The disturbance is not better accounted for by another mental disorder (e.g., major depressive disorder, bipolar disorder).

It's important to note that the diagnosis of substance-induced psychosis requires a thorough medical and psychiatric evaluation to determine if the symptoms are caused by substance use or another underlying mental health condition.

Catalepsy is a medical condition characterized by a trance-like state, with reduced sensitivity to pain and external stimuli, muscular rigidity, and fixed postures. In this state, the person's body may maintain any position in which it is placed for a long time, and there is often a decreased responsiveness to social cues or communication attempts.

Catalepsy can be a symptom of various medical conditions, including neurological disorders such as epilepsy, Parkinson's disease, or brain injuries. It can also occur in the context of mental health disorders, such as severe depression, catatonic schizophrenia, or dissociative identity disorder.

In some cases, catalepsy may be induced intentionally through hypnosis or other forms of altered consciousness practices. However, when it occurs spontaneously or as a symptom of an underlying medical condition, it can be a serious concern and requires medical evaluation and treatment.

Dopamine antagonists are a class of drugs that block the action of dopamine, a neurotransmitter in the brain associated with various functions including movement, motivation, and emotion. These drugs work by binding to dopamine receptors and preventing dopamine from attaching to them, which can help to reduce the symptoms of certain medical conditions such as schizophrenia, bipolar disorder, and gastroesophageal reflux disease (GERD).

There are several types of dopamine antagonists, including:

1. Typical antipsychotics: These drugs are primarily used to treat psychosis, including schizophrenia and delusional disorders. Examples include haloperidol, chlorpromazine, and fluphenazine.
2. Atypical antipsychotics: These drugs are also used to treat psychosis but have fewer side effects than typical antipsychotics. They may also be used to treat bipolar disorder and depression. Examples include risperidone, olanzapine, and quetiapine.
3. Antiemetics: These drugs are used to treat nausea and vomiting. Examples include metoclopramide and prochlorperazine.
4. Dopamine agonists: While not technically dopamine antagonists, these drugs work by stimulating dopamine receptors and can be used to treat conditions such as Parkinson's disease. However, they can also have the opposite effect and block dopamine receptors in high doses, making them functionally similar to dopamine antagonists.

Common side effects of dopamine antagonists include sedation, weight gain, and movement disorders such as tardive dyskinesia. It's important to use these drugs under the close supervision of a healthcare provider to monitor for side effects and adjust the dosage as needed.

Phencyclidine (PCP) is a dissociative drug that was originally developed as an intravenous anesthetic in the 1950s. It can lead to distortions of time, space and body image, hallucinations, and a sense of physical invulnerability.

It can also cause numbness, loss of coordination, and aggressive behavior. High doses can lead to seizures, coma, and death. Long-term use can lead to memory loss, difficulties with speech and thinking, and mental health issues such as depression and suicidal thoughts. It is classified as a Schedule II drug in the United States, indicating it has a high potential for abuse but also an accepted medical use.

Serotonin antagonists are a class of drugs that block the action of serotonin, a neurotransmitter, at specific receptor sites in the brain and elsewhere in the body. They work by binding to the serotonin receptors without activating them, thereby preventing the natural serotonin from binding and transmitting signals.

Serotonin antagonists are used in the treatment of various conditions such as psychiatric disorders, migraines, and nausea and vomiting associated with cancer chemotherapy. They can have varying degrees of affinity for different types of serotonin receptors (e.g., 5-HT2A, 5-HT3, etc.), which contributes to their specific therapeutic effects and side effect profiles.

Examples of serotonin antagonists include ondansetron (used to treat nausea and vomiting), risperidone and olanzapine (used to treat psychiatric disorders), and methysergide (used to prevent migraines). It's important to note that these medications should be used under the supervision of a healthcare provider, as they can have potential risks and interactions with other drugs.

Dopamine D2 receptor is a type of metabotropic G protein-coupled receptor that binds to the neurotransmitter dopamine. It is one of five subtypes of dopamine receptors (D1-D5) and is encoded by the gene DRD2. The activation of D2 receptors leads to a decrease in the activity of adenylyl cyclase, which results in reduced levels of cAMP and modulation of ion channels.

D2 receptors are widely distributed throughout the central nervous system (CNS) and play important roles in various physiological functions, including motor control, reward processing, emotion regulation, and cognition. They are also involved in several neurological and psychiatric disorders, such as Parkinson's disease, schizophrenia, drug addiction, and Tourette syndrome.

D2 receptors have two main subtypes: D2 short (D2S) and D2 long (D2L). The D2S subtype is primarily located in the presynaptic terminals and functions as an autoreceptor that regulates dopamine release, while the D2L subtype is mainly found in the postsynaptic neurons and modulates intracellular signaling pathways.

Antipsychotic drugs, which are used to treat schizophrenia and other psychiatric disorders, work by blocking D2 receptors. However, excessive blockade of these receptors can lead to side effects such as extrapyramidal symptoms (EPS), tardive dyskinesia, and hyperprolactinemia. Therefore, the development of drugs that selectively target specific subtypes of dopamine receptors is an active area of research in the field of neuropsychopharmacology.

Dibenzazepines are a class of chemical compounds that contain a dibenzazepine structure, which is a fusion of a benzene ring with a diazepine ring. Dibenzazepines have a wide range of pharmacological activities and are used in the treatment of various medical conditions.

Some of the medically relevant dibenzazepines include:

1. Antipsychotics: Some antipsychotic drugs, such as clozapine and olanzapine, have a dibenzazepine structure. These drugs are used to treat schizophrenia and other psychotic disorders.
2. Antidepressants: Mianserin and mirtazapine are dibenzazepine antidepressants that work by blocking the uptake of serotonin and noradrenaline in the brain. They are used to treat depression, anxiety, and insomnia.
3. Anticonvulsants: Some anticonvulsant drugs, such as levetiracetam and brivaracetam, have a dibenzazepine structure. These drugs are used to treat epilepsy and other seizure disorders.
4. Anxiolytics: Prazepam is a benzodiazepine derivative with a dibenzazepine structure that is used to treat anxiety disorders.
5. Analgesics: Tramadol is a centrally acting analgesic with a dibenzazepine structure that is used to treat moderate to severe pain.

It's important to note that while these drugs have a dibenzazepine structure, they may also contain other functional groups and have different mechanisms of action. Therefore, it's essential to consider the specific pharmacological properties of each drug when prescribing or administering them.

Basal ganglia diseases are a group of neurological disorders that affect the function of the basal ganglia, which are clusters of nerve cells located deep within the brain. The basal ganglia play a crucial role in controlling movement and coordination. When they are damaged or degenerate, it can result in various motor symptoms such as tremors, rigidity, bradykinesia (slowness of movement), and difficulty with balance and walking.

Some examples of basal ganglia diseases include:

1. Parkinson's disease - a progressive disorder that affects movement due to the death of dopamine-producing cells in the basal ganglia.
2. Huntington's disease - an inherited neurodegenerative disorder that causes uncontrolled movements, emotional problems, and cognitive decline.
3. Dystonia - a movement disorder characterized by sustained or intermittent muscle contractions that cause twisting and repetitive movements or abnormal postures.
4. Wilson's disease - a rare genetic disorder that causes excessive copper accumulation in the liver and brain, leading to neurological and psychiatric symptoms.
5. Progressive supranuclear palsy (PSP) - a rare brain disorder that affects movement, gait, and balance, as well as speech and swallowing.
6. Corticobasal degeneration (CBD) - a rare neurological disorder characterized by progressive loss of nerve cells in the cerebral cortex and basal ganglia, leading to stiffness, rigidity, and difficulty with movement and coordination.

Treatment for basal ganglia diseases varies depending on the specific diagnosis and symptoms but may include medication, surgery, physical therapy, or a combination of these approaches.

A serotonin receptor, specifically the 5-HT2A subtype (5-hydroxytryptamine 2A receptor), is a type of G protein-coupled receptor found in the cell membrane. It is activated by the neurotransmitter serotonin and plays a role in regulating various physiological processes, including mood, cognition, sleep, and sensory perception.

The 5-HT2A receptor is widely distributed throughout the central nervous system and has been implicated in several neurological and psychiatric disorders, such as depression, anxiety, schizophrenia, and migraine. It is also the primary target of several psychoactive drugs, including hallucinogens like LSD and psilocybin, as well as atypical antipsychotics used to treat conditions like schizophrenia.

The 5-HT2A receptor signals through a G protein called Gq, which activates a signaling cascade that ultimately leads to the activation of phospholipase C and the production of second messengers such as inositol trisphosphate (IP3) and diacylglycerol (DAG). These second messengers then go on to modulate various cellular processes, including the release of neurotransmitters and the regulation of gene expression.

Dopamine receptors are a type of G protein-coupled receptor that bind to and respond to the neurotransmitter dopamine. There are five subtypes of dopamine receptors (D1-D5), which are classified into two families based on their structure and function: D1-like (D1 and D5) and D2-like (D2, D3, and D4).

Dopamine receptors play a crucial role in various physiological processes, including movement, motivation, reward, cognition, emotion, and neuroendocrine regulation. They are widely distributed throughout the central nervous system, with high concentrations found in the basal ganglia, limbic system, and cortex.

Dysfunction of dopamine receptors has been implicated in several neurological and psychiatric disorders, such as Parkinson's disease, schizophrenia, attention deficit hyperactivity disorder (ADHD), drug addiction, and depression. Therefore, drugs targeting dopamine receptors have been developed for the treatment of these conditions.

Serotonin 5-HT2 receptor antagonists are a class of drugs that block the action of serotonin, a neurotransmitter, at 5-HT2 receptors. These receptors are found in the central and peripheral nervous systems and are involved in various physiological functions such as mood regulation, cognition, appetite control, and vasoconstriction.

By blocking the action of serotonin at these receptors, serotonin 5-HT2 receptor antagonists can produce a range of effects depending on the specific receptor subtype that they target. For example, some serotonin 5-HT2 receptor antagonists are used to treat psychiatric disorders such as schizophrenia and depression, while others are used to treat migraines or prevent nausea and vomiting associated with chemotherapy.

Some common examples of serotonin 5-HT2 receptor antagonists include risperidone, olanzapine, and paliperidone (used for the treatment of schizophrenia), mirtazapine (used for the treatment of depression), sumatriptan (used for the treatment of migraines), and ondansetron (used to prevent nausea and vomiting).

A startle reaction is a natural, defensive response to an unexpected stimulus that is characterized by a sudden contraction of muscles, typically in the face, neck, and arms. It's a reflexive action that occurs involuntarily and is mediated by the brainstem. The startle reaction can be observed in many different species, including humans, and is thought to have evolved as a protective mechanism to help organisms respond quickly to potential threats. In addition to the muscle contraction, the startle response may also include other physiological changes such as an increase in heart rate and blood pressure.

Serotonin receptors are a type of cell surface receptor that bind to the neurotransmitter serotonin (5-hydroxytryptamine, 5-HT). They are widely distributed throughout the body, including the central and peripheral nervous systems, where they play important roles in regulating various physiological processes such as mood, appetite, sleep, memory, learning, and cognition.

There are seven different classes of serotonin receptors (5-HT1 to 5-HT7), each with multiple subtypes, that exhibit distinct pharmacological properties and signaling mechanisms. These receptors are G protein-coupled receptors (GPCRs) or ligand-gated ion channels, which activate intracellular signaling pathways upon serotonin binding.

Serotonin receptors have been implicated in various neurological and psychiatric disorders, including depression, anxiety, schizophrenia, and migraine. Therefore, selective serotonin receptor agonists or antagonists are used as therapeutic agents for the treatment of these conditions.

Loxapine is an antipsychotic medication that is primarily used to treat schizophrenia. It belongs to a class of drugs called tricyclic antipsychotics, which work by blocking dopamine receptors in the brain. Loxapine can help reduce the symptoms of schizophrenia such as hallucinations, delusions, and disordered thinking. In addition to its use in treating schizophrenia, loxapine may also be used off-label for the treatment of agitation and aggression in individuals with dementia or other mental health disorders.

It is important to note that loxapine can have serious side effects, including neurological symptoms such as tremors, stiffness, and uncontrolled muscle movements, as well as cardiovascular symptoms such as low blood pressure and abnormal heart rhythms. Therefore, it should only be prescribed by a healthcare professional who is experienced in managing the use of antipsychotic medications.

Agranulocytosis is a medical condition characterized by an abnormally low concentration of granulocytes (a type of white blood cells) in the peripheral blood. Granulocytes, which include neutrophils, eosinophils, and basophils, play a crucial role in the body's defense against infections. A significant reduction in their numbers can make an individual highly susceptible to various bacterial and fungal infections.

The condition is typically defined as having fewer than 150 granulocytes per microliter of blood or less than 1% of the total white blood cell count. Symptoms of agranulocytosis may include fever, fatigue, sore throat, mouth ulcers, and susceptibility to infections. The condition can be caused by various factors, including certain medications, medical treatments (such as chemotherapy or radiation therapy), autoimmune disorders, and congenital conditions. Immediate medical attention is required for individuals diagnosed with agranulocytosis to prevent and treat potential infections and restore the normal granulocyte count.

Apomorphine is a non-selective dopamine receptor agonist, which means that it activates dopamine receptors in the brain. It has a high affinity for D1 and D2 dopamine receptors and is used medically to treat Parkinson's disease, particularly in cases of severe or intractable motor fluctuations.

Apomorphine can be administered subcutaneously (under the skin) as a solution or as a sublingual (under the tongue) film. It works by stimulating dopamine receptors in the brain, which helps to reduce the symptoms of Parkinson's disease such as stiffness, tremors, and difficulty with movement.

In addition to its use in Parkinson's disease, apomorphine has also been investigated for its potential therapeutic benefits in other neurological disorders, including alcohol use disorder and drug addiction. However, more research is needed to establish its safety and efficacy in these conditions.

Dopamine D4 receptor (DRD4) is a type of dopamine receptor that belongs to the family of G protein-coupled receptors. It is activated by the neurotransmitter dopamine and plays a role in various physiological functions, including regulation of movement, motivation, reward processing, cognition, and emotional responses.

The DRD4 gene contains a variable number of tandem repeats (VNTR) polymorphism in its coding region, which results in different isoforms of the receptor with varying lengths of the third intracellular loop. This genetic variation has been associated with several neuropsychiatric disorders, such as attention-deficit/hyperactivity disorder (ADHD), substance use disorders, and personality traits like novelty seeking.

The D4 receptor is widely expressed in the brain, particularly in the limbic system, prefrontal cortex, hippocampus, and amygdala. It has a lower affinity for dopamine than other dopamine receptors (D1-D3) and exhibits a slower rate of dissociation from dopamine, suggesting that it may act as a modulator of dopaminergic signaling rather than a primary mediator.

In summary, the Dopamine D4 receptor is a type of dopamine receptor involved in various physiological functions and has been associated with several neuropsychiatric disorders due to genetic variations in its coding region.

I must clarify that there is no such thing as "Schizophrenic Psychology." The term schizophrenia is used to describe a specific and serious mental disorder that affects how a person thinks, feels, and behaves. It's important not to use the term casually or inaccurately, as it can perpetuate stigma and misunderstanding about the condition.

Schizophrenia is characterized by symptoms such as hallucinations (hearing or seeing things that aren't there), delusions (false beliefs that are not based on reality), disorganized speech, and grossly disorganized or catatonic behavior. These symptoms can impair a person's ability to function in daily life, maintain relationships, and experience emotions appropriately.

If you have any questions related to mental health conditions or psychology, I would be happy to provide accurate information and definitions.

... is on the World Health Organization's List of Essential Medicines. It is available as a generic medication. Clozapine ... Clozapine is not normally associated with tardive dyskinesia (TD) and is recommended as the drug of choice when this is present ... Clozapine is regarded as the gold-standard treatment when most other medications are ineffective and its use is recommended by ... Clozapine's use is therefore usually reserved for people who have not responded to at least two other antipsychotics and is ...
It is a prodrug of clozapine; the fatty acid docosahexaenoic acid (DHA) was added to clozapine in order to increase penetration ... DHA-clozapine (tentative trade name Clozaprexin) is an atypical antipsychotic drug candidate that was created and originally ... "DHA-clozapine". AdisInsight. Retrieved 17 March 2017. Rosack, Jim (4 May 2001). "Targaceuticals Point Way To Developing Safer ... January 2001). "Fatty acid derivatives of clozapine: prolonged antidopaminergic activity of docosahexaenoylclozapine in the rat ...
"The DREADD agonist clozapine N-oxide (CNO) is reverse-metabolized to clozapine and produces clozapine-like interoceptive ... Clozapine N-oxide (CNO) is a synthetic drug used mainly in biomedical research as a ligand to activate DREADD receptors. ... it has been shown not to enter the brain after administration and to reverse metabolise in vivo into clozapine which has a ... DREADD occupancy and activation via converted clozapine". Science. 357 (6350): 503-507. Bibcode:2017Sci...357..503G. doi: ...
Clozapine • Gevotroline • Iloperidone • Lurasidone • Melperone • Molindone • Mosapramine • Ocaperidone • Olanzapine • ...
Clothiapine and clozapine]". Minerva Psichiatrica. 34 (2): 95-9. PMID 8105359. Schmutz J, Künzle F, Hunziker F, Gauch R (1967 ... rather than atypical due to its high incidence of extrapyramidal side effects compared to the atypicals like clozapine and ...
The atypical antipsychotic clozapine in particular is largely restricted to treatment-resistant cases and mandatory blood count ... Mijovic A, MacCabe JH (November 2020). "Clozapine-induced agranulocytosis". Ann Hematol. 99 (11): 2477-2482. doi:10.1007/s00277 ...
For people with any tardive conditions clozapine remains an option but since it can create blood dyscrasias, which require ... Ross, David E (2004). "Clozapine and Typical Antipsychotics". American Journal of Psychiatry. 161 (10): 1925-6. doi:10.1176/ajp ... psychosis articles focus on psychotic episodes in the wake of psychotic medication withdrawal associated with Clozapine, rather ...
Regular CBCs are necessary for people taking some psychiatric drugs, such as clozapine and carbamazepine, which in rare cases ... Wiciński, M; Węclewicz, MM (2018). "Clozapine-induced agranulocytosis/granulocytopenia". Current Opinion in Hematology. 25 (1 ...
He has also developed a genetic test predicting response to clozapine and the risk of agranulocytosis. This test is marketed in ... Taylor's research has helped further understanding of the use of clozapine. In 2022 he suggested a refined phenotype for ... Taylor, David (August 1997). "Pharmacokinetic interactions involving clozapine". The British Journal of Psychiatry. 171 (2): ... "International trends in clozapine use: a study in 17 countries". Acta Psychiatrica Scandinavica. 136 (1): 37-51. doi:10.1111/ ...
2007). "Clozapine-associated myocarditis: a review of 116 cases of suspected myocarditis associated with the use of clozapine ... and clozapine will be offered. Clozapine is of benefit to around half of this group although it has the potentially serious ... Clozapine is the only medication proven to be more effective for people who do not respond to other types of antipsychotics. It ... As clozapine suppresses the development of bone marrow, in turn reducing white blood cells which can lead to infection, blood ...
clozapine, aripiprazole Tricyclic antidepressants- ex. clomipramine Psychoactive drugs Antiemetic drugs Cholinesterase ...
Esposito D, Aouillé J, Rouillon F, Limosin F (October 2003). "Morning pseudoneutropenia during clozapine treatment". The World ... Ahokas A, Elonen E (June 1999). "Circadian rhythm of white blood cells during clozapine treatment". Psychopharmacology. 144 (3 ... Case reports of such incidents are reported with clozapine, risperidone, and aripiprazole. These case reports suggest that the ...
... clozapine, etc.) Hypnotics (zolpidem, zopiclone, chloral hydrate, eszopiclone, etc.) Muscle relaxants (baclofen, phenibut, ...
Harper, D.N. (1999a). Behavioral resistance to haloperidol and clozapine. Behavioural Processes, 46, 1-13. Harper, D.N. (1999b ...
J. Alvir (1993). "Clozapine-Induced Agranulocytosis -- Incidence and Risk Factors in the United States". New England Journal of ... Hibbard KR, Propst A, Frank DE, Wyse J (2009). "Fatalities associated with clozapine-related constipation and bowel obstruction ... Rege S, Lafferty T (2008). "Life-threatening constipation associated with clozapine". Australas Psychiatry. 16 (3): 216-9. doi: ...
"Does clozapine treatment cause brain disease?" Archives of General Psychiatry, 55(9):845, 1998. 40. Breggin, Peter. " ...
Richardson C, Kelly DL, Conley RR (August 2001). "Biperiden for excessive sweating from clozapine". Am J Psychiatry. 158 (8): ... It relieves muscle rigidity, reduces abnormal sweating related with clozapine and methadone use and salivation, improves ...
As of 2008, it is unclear if medication for people who have too much saliva due to clozapine treatment is useful. ... "Pharmacological interventions for clozapine-induced hypersalivation". The Cochrane Database of Systematic Reviews (3): CD005579 ... aripiprazole clozapine pilocarpine ketamine potassium chlorate risperidone pyridostigmine Substances that can cause ...
However, various publications and textbooks have expressed that lamotrigine could be added to clozapine as augmentation therapy ... Tiihonen J, Wahlbeck K, Kiviniemi V (April 2009). "The efficacy of lamotrigine in clozapine-resistant schizophrenia: a ... Lamotrigine does not have a statistically significant effect with antipsychotics other than clozapine, such as: olanzapine, ... Dursun SM, McIntosh D, Milliken H (October 1999). "Clozapine plus lamotrigine in treatment-resistant schizophrenia". Archives ...
Clozapine, Olanzapine, Quetiapine, Risperidone, Ziprasidone, etc.) Cinanserin Deramciclane Ketanserin LY-53,857 Metergoline ...
... also has some weak antipsychotic effects with a profile of activity described as similar to that of clozapine, and ... Gross G, Xin X, Gastpar M (1991). "Trimipramine: pharmacological reevaluation and comparison with clozapine". Neuropharmacology ... these both being properties it shares with clozapine. Unlike other TCAs, but reminiscent of antipsychotics, trimipramine has ... monoamine receptors including the D2 and 5-HT2A receptors closely resemble those of the atypical antipsychotic clozapine. In ...
Clozapine is an effective treatment for those who respond poorly to other drugs ("treatment-resistant" or "refractory" ... Essali A, Al-Haj Haasan N, Li C, Rathbone J (January 2009). "Clozapine versus typical neuroleptic medication for schizophrenia ... Tentative evidence supports that amisulpride, olanzapine, risperidone and clozapine may be more effective for positive symptoms ...
Schulte, P. (2003). "What is an adequate trial with clozapine?: therapeutic drug monitoring and time to response in treatment- ... Clozapine - used in treatment-resistant schizophrenia not responsive to at least two different antipsychotics; the main reason ...
... and clozapine will be offered. Clozapine is of benefit to around half of this group although it has the potentially serious ... The use of clozapine can reduce the risk of suicide, and of aggression. A strong association between schizophrenia and tobacco ... Up to a third of people do not respond to initial antipsychotics, in which case clozapine may be used. In a network comparative ... The antipsychotic clozapine is also associated with thromboembolism (including pulmonary embolism), myocarditis, and ...
The current consensus in global psychiatry is that both lithium and clozapine remain the most effective agents in the treatment ... Bogers, Jan P. A. M.; Schulte, Peter F. J.; Van Dijk, Daniel; Bakker, Bert; Cohen, Dan (April 2016). "Clozapine ... Frances has expressed his belief that both lithium carbonate and clozapine are underutilized in the treatment of bipolar ... and the use of clozapine for schizophrenia. Regarding electroconvulsive therapy, Frances argues that the treatment can be ...
... clozapine (SMD: 0.65; 95% CI: 0.31-0.99), zotepine (SMD: 0.71; 95% CI: 0.47-0.96) and olanzapine (SMD: 0.74; 95% CI: 0.67-0.81 ...
An in vitro approach comparing amisulpride with clozapine". Neuropsychopharmacology. 28 (11): 1916-22. doi:10.1038/sj.npp. ...
"Clozapine N-oxide (CNO) freebase stability and storage". HelloBio.com. Retrieved 2018-12-05. Urban DJ, Roth BL (2015-01-06). " ... Clozapine is an atypical antipsychotic which has been indicated to show high DREADD affinity and potency. Subthreshold ... like clozapine N-oxide (CNO), and not to endogenous ligands. Several types of these receptors exists, derived from muscarinic ... pharmacokinetic properties and brain penetrability and does not undergo reverse metabolism to clozapine. Another known agonist ...
... which led to FDA approval of clozapine for treating suicide. He also discovered that clozapine can improve cognition. Meltzer ... "Pioneer in Clozapine Research Wins Major Psychopharmacology Award". PsychNews. doi:10.1176/appi.pn.2016.PP7a2 (inactive 1 ... Meltzer, H; Alphs, L; Green, A; Altamura, A; Anand, R; Bertoldi, A (2003). "Clozapine treatment for suicidality in ... During his research career, Meltzer discovered the effectiveness of clozapine in treating suicide attempts in patients with ...
... manufactures the drugs clozapine (Clozaril), diclofenac (Voltaren; sold to GlaxoSmithKline in 2015 deal), ...
Clozapine is on the World Health Organizations List of Essential Medicines. It is available as a generic medication. Clozapine ... Clozapine is not normally associated with tardive dyskinesia (TD) and is recommended as the drug of choice when this is present ... Clozapine is regarded as the gold-standard treatment when most other medications are ineffective and its use is recommended by ... Clozapines use is therefore usually reserved for people who have not responded to at least two other antipsychotics and is ...
Clozapine: learn about side effects, dosage, special precautions, and more on MedlinePlus ... Continue to take clozapine even if you feel well. Do not stop taking clozapine without talking to your doctor. Your doctor will ... Before taking clozapine,. *tell your doctor and pharmacist if you are allergic to clozapine, any other medications, or any of ... A program has been set up by the manufacturers of clozapine to be sure that people do not take clozapine without the necessary ...
5.2 Clozapine REMS Program. Clozapine is only available through a restricted program under a REMS called the Clozapine REMS ... Initiating clozapine tablets while taking a co-medication Adding a co-medication while taking clozapine tablets Discontinuing a ... Thus, clozapine may be administered with or without food. Distribution Clozapine is approximately 97% bound to serum proteins. ... 7.1 Potential for Other Drugs to Affect Clozapine 7.2 Potential for Clozapine to Affect Other Drugs 8 USE IN SPECIFIC ...
This report presents a unique case of concurrent pneumonia and pancreatitis following clozapine initiation and recurrence of ... Successful clozapine rechallenge following recurrent clozapine-associated pancreatitis: a case report. BMC Pharmacol Toxicol. ... He had an initial trial of clozapine by age 28 years due to treatment-resistant schizophrenia. At clozapine commencement, he ... Moreover, clozapine-induced pancreatitis recurrence at a lower clozapine dose, accompanying eosinophilia, faster symptom onset ...
Clozapine has previously been found in purified wastewater in Stockholm County (2005-2012). Clozapine has not been analyzed in ... Underlying data for P, B, T and risk are from Leponex (clozapine) downloaded 2011-04-29. No new environmental information for ... The reduction rate for clozapine in wastewater treatment plants in Stockholm County is between 28 and 49 %. ... clozapine is published on Fass.se (2018-09-04). It is voluntary for manufacturers to provide information about environmental ...
This is recommendation 12: Clozapine. These recommendations are designed to assist providers in all aspects of suicide ... VA National Clozapine Coordinating Center. An invaluable resource for VA clozapine prescribers. NCCC can offer consultation for ... VHA Directive 1108.17: Clozapine Patient Management Handbook Return to Resource Options Webinars. This section includes links ... National Clozapine Coordination Center (NCCC) SharePoint (VA Intranet access required). Return to Resource Options Manuals. ...
Clozapine: safe prescribing. In 2014, bpacnz published an article on the safer prescribing of clozapine. Since this time, a ... Clozapine - safe prescribing - we are counting on you. 2014. Available from: www.saferx.co.nz/full/clozapine.pdf (Accessed Jul ... Table 3: Mechanisms and examples of interactions with clozapine.. Induction of CYP1A2 may decrease clozapine plasma levels. ... Prescribing of clozapine is restricted. Clozapine treatment is initiated by a psychiatrist, ideally as soon as treatment- ...
When Clozapine Is Not An Option: After 30 years, Mr. S catatonic schizophrenia finally responds to medication, but the drug ... We start clozapine, 400 mg/d, and order twice-monthly blood tests to check for clozapine-induced agranulocytosis.. After nearly ... Clozapine monotherapy for catatonic schizophrenia: should clozapine be the treatment of choice, with catatonia rather than ... Serum clozapine is 363 ng/mL.. How would you have treated Mr. S delusions and impulsive behavior at this stage?. __ try ...
Clinical studies have shown clozapine to be effective in suppres … ... Clozapine, an antipsychotic agent of the dibenzodiazepine class, is characterised by relatively weak central dopaminergic ... Clozapine. A review of its pharmacological properties, and therapeutic use in schizophrenia Drugs. 1990 Nov;40(5):722-47. doi: ... Moreover, clozapine is effective in a substantial proportion (30 to 50%) of schizophrenic patients who are refractory to or ...
... J Nerv Ment Dis. 2009 Nov; ... control group in patients with schizophrenia who are refractory to clozapine. Twenty-one patients completed the 21-week trial. ...
Value of clozapine in treatment of psychotic disorder in Parkinson disease]. Download Prime PubMed App to iPhone, iPad, or ... Clozapine: new preparation. A last resort for parkinsonian patients with psychosis.. *[Clozapine in the treatment of adverse ... The emerging role of clozapine in the treatment of movement disorders.. *Combined clozapine and electroconvulsive therapy for ... were the first to report the use of clozapine in drug-induced psychosis in PD. The rationale for use of clozapine in ...
The mean dose of clozapine at the first occurrence of seizure was 383.3 mg/day. Five of six patients who experienced seizures ... EEG measurements were obtained prior to clozapine treatment and every 4 weeks thereafter. EEG measurements were also obtained ... PANSS (T) scores were used to determine clozapine treatment outcome. Results: All 26 patients had normal baseline EEG ... EEG abnormalities that appeared after clozapine treatment were associated with a good clinical response. Keywords: treatment- ...
FDA warns that untreated constipation caused by schizophrenia drug clozapine (Clozaril) can get worse and lead to serious bowel ... What is clozapine and how can it help me? Clozapine is a medicine that has been used for more than 40 years to treat ... Facts about Clozapine (Clozaril, Fazaclo ODT, Versacloz) *Clozapine is a medicine used to treat schizophrenia in patients whose ... We found that because of the way clozapine works this risk is greater with clozapine than with the other schizophrenia ...
Clozapine has a great capacity to decrease violence, aggression, and suicidal behavior. We have shown clozapine substantially ... In the group that agreed to try clozapine, patients actually receiving clozapine continued longer than patients taking ... We know that clozapine had better efficacy from other studies, he told Psychiatric Times. If you look at the long-term ... CATIE Phase 2: Clozapine Most Effective, Followed by Risperidone, Olanzapine. June 1, 2006. Richard A. Sherer ...
... with clozapine variables as covariates (i.e, the dose of clozapine, as well as the levels of serum clozapine and nor-clozapine ... signs are correlated with clozapine dose titration and blood levels of clozapine and nor-clozapine during clozapine therapy. ... The temperature was inversely related to clozapine dose (p<0.003). Higher nor-clozapine to clozapine ratios were associated ... After obtaining informed consent, serum concentrations of clozapine and nor-clozapine were determined weekly at trough, as ...
Savvy Psychopharmacology Feature: What To Do When Your Patient Who Takes Clozapine Enters A Smoke-Free Facility. ... authored this months article on What To Do When Your Patient Who Takes Clozapine Enters A Smoke-Free Facility. ...
A requirement of the clozapine REMS program is the monitoring of ANC before each prescription of clozapine can be dispensed.15 ... The Clozapine Risk Evaluation and Mitigation Strategy (REMS) Program M [Internet]. . The Clozapine Risk Evaluation and ... For example, under to the clozapine REMS program, providers are instructed to report clozapine-related adverse events directly ... As such, our findings of increased hematologic adverse event reporting with clozapine after the introduction of the clozapine ...
MH Update - 3/21/20 - OMH COVID-19 Guidance- Clozapine and Blood Test Monitoring ...
Moreover, Treg function was dispensable for disease protection by clozapine. Instead, disease protection by clozapine was ... However, although clozapine effectively delayed disease onset and reduced the severity of EAE, the therapeutic effect of ... This thesis aimed to describe the immunological mechanisms by which clozapine is able to reduce EAE disease and to determine ... Although atypical antipsychotic agents like clozapine have been used in the clinic for almost 60 years, there is very little ...
In addition, a clozapine order set was created to assist providers with initiation of clozapine. Lastly, a Clozapine Dashboard ... In just over a year, the number of clozapine providers has increased and so has the number of new clozapine starts. There has ... Some presume the underuse of clozapine is due to the monitoring required for use of the drug; however, clozapine is utilized ... Clozapine: Underused and misunderstood Mary C. Borovicka, PharmD, BCPS, BCPP Mary C. Borovicka, PharmD, BCPS, BCPP ...
Clozapine prophylaxis in rapid cycling bipolar disorder. / Calabrese, Joseph R.; Meltzer, Herbert Y.; Markovitz, Paul J. In: ... Calabrese, J. R., Meltzer, H. Y., & Markovitz, P. J. (1991). Clozapine prophylaxis in rapid cycling bipolar disorder. Journal ... Calabrese, Joseph R. ; Meltzer, Herbert Y. ; Markovitz, Paul J. / Clozapine prophylaxis in rapid cycling bipolar disorder. In: ... Clozapine prophylaxis in rapid cycling bipolar disorder. Journal of Clinical Psychopharmacology. 1991 Jan 1;11(6):396-397. ...
However, clozapine patients experienced fewer motor adverse effects (n=1433, 18 RCTs, RR 0.58 CI 0.5 to 0.7, NNT 5 CI 4 to 6). ... Clozapine is an antipsychotic drug, which is claimed to have superior efficacy and to cause fewer motor adverse effects than ... Clozapine versus typical neuroleptic medication for schizophrenia.. Adib Essali, Nahla Al-Haj Haasan, Chunbo Li, John Rathbone ... Clozapine carries a significant risk of serious blood disorders, which necessitates mandatory weekly blood monitoring at least ...
3 due to clozapine-related agranulocytosis and 15 due to ileus (blockage of the intestines). If only 20% started clozapine, ... Deaths from clozapine-related adverse events are more than balanced out by decreased incidence of suicide attempts, with a net ... Use of Clozapine for Veterans with Treatment-Resistant Schizophrenia Could Result in Significant Cost Savings. BACKGROUND:. ... Modest increases in clozapine use could result in significant cost savings for VA. Among Veterans with treatment-resistant ...
Our Mission is to provide reliable, timely, accurate, cost effective and innovative diagnostic services and information to patients, physicians, and other health care providers for the benefit of the patient.. Read more. ...
Retrieved from "https://wiki.psychiatrienet.nl/w/index.php?title=Clozapine&oldid=5571" ...
Limit of Quantification; Clozapine / Norclozapine (µg/l). 11.05 / 6.46. Linearity; Clozapine / Norclozapine (µg/l). 2000 / 2650 ... Simple Precision; Clozapine / Norclozapine (CV %). , 2.4 / , 3.3. Complex Precision; Clozapine / Norclozapine (CV %). , 4.9 ... clozapine). Therapeutic Drug Monitoring (TDM) is based on the assumption that there is a relationship between the blood ... and the antipsychotic clozapine (including the metabolite norclozapine). ...
Clozapine. Clozapine is an atypical or second-generation antipsychotic medication that has been well accepted for the treatment ... Clozapine was not mentioned in the Expert Consensus Guidelines, as at the time the guidelines were written, not much data ... By and large, a dose of 300-600 mg seems to be useful for patients when a minimum clozapine blood level of 350 ng/mL is ... Sabaawi M, Singh NN, de Leon J. Guidelines for the use of clozapine in individuals with developmental disabilities. Res Dev ...
  • The role of clozapine in treatment-resistant schizophrenia was established by a 1988 landmark multicenter double blind study in which clozapine (up to 900mg/d) showed marked benefits compared to chlorpromazine (up to 1800mg/d) in a group of patients with protracted psychosis who had already shown an inadequate response to at least three previous antipsychotics including a prior single blind trial of haloperidol (mean 61+/- 14mg/d for six weeks). (wikipedia.org)
  • Overall, despite the concerns relating to blood and other side effects, clozapine use is associated with a reduced mortality, especially from suicide which is a major cause of premature death in people with schizophrenia. (wikipedia.org)
  • Clozapine became widely available in the early 1990s and remains the only treatment likely to be effective in treating resistant schizophrenia. (wikipedia.org)
  • Clozapine is used to treat the symptoms of schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions) in people who have not been helped by other medications or who have tried to kill themselves and are likely to try to kill or harm themselves again. (medlineplus.gov)
  • He had an initial trial of clozapine by age 28 years due to treatment-resistant schizophrenia. (psychiatrist.com)
  • Due to Mr A's treatment-resistant schizophrenia, a clozapine rechallenge was considered. (psychiatrist.com)
  • We suggest offering clozapine to decrease the risk of death by suicide in patients with schizophrenia or schizoaffective disorder and either suicidal ideation or a history of suicide attempt(s). (va.gov)
  • Clozapine is an atypical antipsychotic medication that has been found to reduce suicidal behaviors in patients diagnosed with schizophrenia or schizoaffective disorder. (va.gov)
  • This section includes links to training resources about offering clozapine to decrease the risk of death to suicide in patients with schizophrenia or schizoaffective disorder. (va.gov)
  • This section includes links to webinars that are recommended about offering clozapine to decrease the risk of death to suicide in patients with schizophrenia or schizoaffective disorder. (va.gov)
  • Clozapine is often effective for patients with treatment-resistant schizophrenia, however, proactive and co-ordinated management is required, which is the primary responsibility of the initiating prescriber. (bpac.org.nz)
  • 1 The medicine was reintroduced following a landmark study in 1988 demonstrating that patients with schizophrenia who were unresponsive to other medicines often found clozapine beneficial. (bpac.org.nz)
  • 2 Since then, clozapine has been shown to be the only medicine to reduce suicidal behaviour in patients with schizophrenia and it is now the medicine of choice for treatment-resistant schizophrenia. (bpac.org.nz)
  • Clozapine treatment is initiated by a psychiatrist, ideally as soon as treatment-resistant schizophrenia is identified. (bpac.org.nz)
  • Clinical studies have shown clozapine to be effective in suppressing both the positive and negative symptoms of schizophrenia and to be associated with an extremely low incidence of extrapyramidal side effects. (nih.gov)
  • Clozapine has been shown to be of comparable, or on some criteria superior, therapeutic efficacy to perphenazine, levomepromazine, haloperidol and chlorpromazine in several short term comparative studies in patients with schizophrenia of predominantly acute symptomatology. (nih.gov)
  • In accordance with current guidelines, clozapine therapy, performed in conjunction with close haematological monitoring, is indicated for the management of severe and chronic schizophrenia refractory to classic antipsychotic therapy, and in those unable to tolerate such therapy. (nih.gov)
  • The aim of this study was to compare the efficacy of CBT to a befriending (BF) control group in patients with schizophrenia who are refractory to clozapine. (nih.gov)
  • The Food and Drug Administration (FDA) is strengthening an existing warning that constipation caused by the schizophrenia medicine clozapine (Clozaril, Fazaclo ODT, Versacloz, generics) can, uncommonly, progress to serious bowel complications. (fda.gov)
  • We found that because of the way clozapine works this risk is greater with clozapine than with the other schizophrenia medicines in its drug class. (fda.gov)
  • Clozapine is a medicine that has been used for more than 40 years to treat schizophrenia in patients whose symptoms are not controlled with standard treatment. (fda.gov)
  • Clozapine is also effective in reducing the risk of suicidal thinking and self-harm in patients with schizophrenia or schizoaffective disorder. (fda.gov)
  • You should not stop taking your clozapine medicine without first talking with your health care professional, as stopping treatment can cause your schizophrenia symptoms to return or worsen. (fda.gov)
  • 1 This is despite overwhelming evidence of its effectiveness for treatment-resistant schizophrenia, suicide prevention in schizophrenia, reductions in hospitalizations, and other pharmacoeconomic data supporting the use of clozapine. (allenpress.com)
  • Use in Scandinavia is nearly 20%, in China 16%, and in Australia as many as 38% of outpatients with schizophrenia receive clozapine. (allenpress.com)
  • Clozapine versus typical neuroleptic medication for schizophrenia. (qxmd.com)
  • To evaluate the effects of clozapine compared with typical antipsychotic drugs in people with schizophrenia. (qxmd.com)
  • Clozapine may be more effective in reducing symptoms of schizophrenia, producing clinically meaningful improvements and postponing relapse, than typical antipsychotic drugs - but data are weak and prone to bias. (qxmd.com)
  • Clozapine is the only treatment proven effective for treatment-resistant schizophrenia, and is FDA-approved to decrease suicidal behavior associated with schizophrenia. (va.gov)
  • Only 20% of Veterans with treatment-resistant schizophrenia in the VA receive clozapine, implying that about 80% are receiving less effective treatments. (va.gov)
  • This cost-benefit analysis sought to simulate potential cost savings for VA that would result from increasing the use of clozapine among Veterans with treatment-resistant schizophrenia. (va.gov)
  • Modest increases in clozapine use could result in significant cost savings for VA. Among Veterans with treatment-resistant schizophrenia, VA would save $22,444 per Veteran over the first year of treatment, primarily from 18.6 fewer inpatient hospitalization days per patient. (va.gov)
  • Given this finding, if current clozapine use was doubled from 20% of patients with treatment-resistant schizophrenia to 40%, VA would accrue an estimated cost savings of $80 million over the first year. (va.gov)
  • If all Veterans with treatment-resistant schizophrenia initiated clozapine, it would result in an additional 743 serious adverse drug reactions (ADRs) in year one. (va.gov)
  • If all Veterans with treatment-resistant schizophrenia initiated clozapine, 19 suicides would be averted, while there would be a total of 18 additional deaths, 3 due to clozapine-related agranulocytosis and 15 due to ileus (blockage of the intestines). (va.gov)
  • Findings suggest VA should strongly consider initiatives to substantially increase clozapine use among Veterans with treatment-resistant schizophrenia. (va.gov)
  • To examine whether clozapine is an effective treatment for the management of aggression behaviour in people with schizophrenia (i.e. not for rapid tranquillisation). (ox.ac.uk)
  • The Clozapine Consultation Clinic at Johns Hopkins Hospital offers a one-time, second opinion evaluation for patients with schizophrenia who may benefit from clozapine. (hopkinsmedicine.org)
  • camp olanzapine depot injection for schizophrenia and clozapine Rectangular shaped sunglasses have many benefits: they can make a round or oval face look more angular, If she says no, nicely end the conversation and now start IGNORING HER for at least 2 clozapine withdrawal catatonia months. (servicevents.fr)
  • Clozapine is increasingly seen as the gold standard for treatment-refractory schizophrenia , although meta-analyses of clozapine for this condition are lacking. (medscape.com)
  • Now a team of investigators [ 1 ] from the University of Queensland, Australia, have conducted a systematic review and meta-analysis of clozapine treatment for people with treatment-refractory schizophrenia. (medscape.com)
  • Clozapine is relatively underutilized in patients who have schizophrenia in the United States, and other recent studies have suggested it should be the treatment of choice for all patients who have had a single failed trial of a different first- or second-generation antipsychotic. (medscape.com)
  • The authors of this meta-analysis concluded that clozapine is superior to other drug treatments for treatment-refractory schizophrenia, but that if there is no response by 6 months, medications with lower adverse reactions should then be considered. (medscape.com)
  • If you are not prescribing clozapine in at least 6-month trials for your patients with treatment-refractory schizophrenia, you need to change your practice and start doing so. (medscape.com)
  • Cite this: Clozapine vs the Rest for Treatment-Refractory Schizophrenia - Medscape - Feb 24, 2017. (medscape.com)
  • Clozapine Best Antipsychotic for Schizophrenia? (medscape.com)
  • BACKGROUND: A proportion of people with treatment-resistant schizophrenia fail to show improvement on clozapine treatment. (ox.ac.uk)
  • Clozapine is regarded as the "gold standard" for treating schizophrenia , one of the most disabling of psychiatric diseases. (smiadviser.org)
  • Clozapine for Treating Schizophrenia: A Comparison of the States utilized Medicaid prescription data in 44 states from 2006-2009 and pharmacy prescription data in all the states for 2009-2011 to compare usage as a measure of states' efforts to treat individuals with schizophrenia. (smiadviser.org)
  • Only a few national schizophrenia guidelines mention clozapine-induced myocarditis or individual titration schemes. (bvsalud.org)
  • Compared to other antipsychotics, clozapine has an increased risk of blood dyscrasias, in particular agranulocytosis, in the first 18 weeks of treatment. (wikipedia.org)
  • The risk of clozapine related agranulocytosis and neutropenia warranted the mandatory use of stringent risk monitoring and management systems, which have reduced the risk of death from these adverse events to around 1 in 7,700. (wikipedia.org)
  • The association between clozapine use and specific blood dyscrasias was first noted in the 1970s when eight deaths from agranulocytosis were noted in Finland. (wikipedia.org)
  • In 1975, 16 cases of agranulocytosis leading to 8 deaths in clozapine-treated patients, reported from 6 hospitals mostly in southwestern Finland, led to concern. (wikipedia.org)
  • This clozapine-induced inflammatory response is potentially related to benign hyperthermia, myocarditis, and agranulocytosis. (psychiatrist.com)
  • Despite its promising therapeutic potential, the relatively high incidence of clozapine-induced agranulocytosis (1 to 2% of patients) is a major factor restricting the drug's wider use in psychiatric practice. (nih.gov)
  • We start clozapine, 400 mg/d, and order twice-monthly blood tests to check for clozapine-induced agranulocytosis. (mhaus.org)
  • We assessed adverse event reports for agranulocytosis, granulocytopenia, leukopenia, and neutropenia from the FDA Adverse Event Reporting System (FAERS) for a 1-year time period before (October 2014 to September 2015, pre-REMS) and after (October 2015 to September 2016, post-REMS) the implementation of the clozapine REMS program. (allenpress.com)
  • The most dangerous form of neutropenia is agranulocytosis, which occurs in 1% of patients taking clozapine, most commonly between 6 and 18 weeks after starting the medication. (smiadviser.org)
  • A case report of clozapine-induced agranulocytosis in a patient treated concomitantly with lithium is reported. (tau.ac.il)
  • Since some of its side-effects, e.g. agranulocytosis, which occurs in nearly 1% of all treated patients, can be life-threatening clozapine is not considered a first-line antipsychotic and should only be administered after two failed treatment attempts with other antipsychotics [ 2 ]. (biomedcentral.com)
  • Psychiatrists tend to focus on the well-known side effects like agranulocytosis and the development of metabolic syndrome when monitoring a clozapine-treated patient, yet the cardiac risk should not be underestimated as we try to demonstrate in our case report. (biomedcentral.com)
  • Furthermore, it is worth mentioning, that agranulocytosis first came into focus as a clozapine-related side-effect in a Finnish case report in 1975, thus stressing the importance of singular case reports in the process of understanding the possible risks of pharmacological treatment [ 7 ]. (biomedcentral.com)
  • While there are significant side effects, clozapine remains the most effective treatment when one or more other antipsychotics have had an inadequate response. (wikipedia.org)
  • Studies have shown that older adults with dementia (a brain disorder that affects the ability to remember, think clearly, communicate, and perform daily activities and that may cause changes in mood and personality) who take antipsychotics (medications for mental illness) such as clozapine have an increased chance of death during treatment. (medlineplus.gov)
  • Clozapine is in a class of medications called atypical antipsychotics. (medlineplus.gov)
  • Clozapine, an antipsychotic agent of the dibenzodiazepine class, is characterised by relatively weak central dopaminergic activity and displays atypical pharmacological and clinical properties in relation to the classic antipsychotics. (nih.gov)
  • In such appropriately selected patients, clozapine represents an important alternative to the classic antipsychotics. (nih.gov)
  • Clozapine monotherapy has shown effectiveness in catatonic schizophrenia7 and might be an option after other antipsychotics have failed. (mhaus.org)
  • Still others feel that perhaps marketing of other second generation antipsychotics has led to the decline in use of clozapine. (allenpress.com)
  • Blood problems occurred more frequently in participants receiving clozapine (3.2%) compared with those given typical antipsychotics (0%) (n=1031, 13 RCTs, RR 7.09 CI 2.0 to 25.6). (qxmd.com)
  • The Diagnotix kit for measuring tricyclic antidepressants (TCAs) and antipsychotics (PS1) includes the TCAs amitriptyline, nortriptyline, clomipramine, imipramine and desipramine (including the drugs' metabolites) and the antipsychotic clozapine (including the metabolite norclozapine). (diagnotix.com)
  • The cumulative dose-dependent increase in odds was about 2.7 times greater for clozapine than for other antipsychotics after long-term exposure, the researchers write. (kepalacinta.com)
  • A 2003 study, commonly cited as evidence that the drug reduces suicide, found that fewer people had suicidal thoughts on clozapine than on other antipsychotics, but there was no statistically significant difference in actual deaths from suicide (in fact, in that studio, Moreover people who died by suicide with clozapine than with other antipsychotics). (kepalacinta.com)
  • The cumulative dose-dependent increase in odds was approximately 2.7-fold greater for clozapine (aOR 335) than for other antipsychotics (aOR 125) after long-term exposure greater than 5 years or 5000 [dose equivalents]. (kepalacinta.com)
  • In this cohort, clozapine use was associated with lower all-cause mortality than all other commonly used antipsychotics. (kepalacinta.com)
  • RESULTS: Clozapine prescription among antipsychotics in 2021 varied six-fold across countries, from 2.8 % in the Czech Republic to 15.8 % in Montenegro. (bvsalud.org)
  • Despite the introduction of new antipsychotics and improved access to Clozapine over the last 50 or so years, the clinical outcome for people with schizophreniform illnesses has shown little demonstrable improvement. (who.int)
  • In the group that did not receive clozapine, patients treated with risperidone and olanzapine continued taking their medications longer than those who were treated with quetiapine or ziprasidone. (psychiatrictimes.com)
  • To receive clozapine, patients must be part of a system that includes a credentialed clinician, regular neutrophil monitoring, and registry reporting of neutrophil counts. (smiadviser.org)
  • These materials included a pamphlet that describes the benefits of clozapine as well as safety and cost data. (allenpress.com)
  • The short-term benefits of clozapine have to be weighed against the risk of adverse effects. (qxmd.com)
  • However, the mortality benefits of clozapine treatment continue to outweigh the risks. (kepalacinta.com)
  • Clozapine may cause myocarditis (swelling of the heart muscle that may be dangerous) or cardiomyopathy (enlarged or thickened heart muscle that stops the heart from pumping blood normally). (medlineplus.gov)
  • However, clozapine is associated with side effects including significant weight gain, diabetes, and myocarditis, as well as significant adverse drug reactions that require compliance with an FDA-mandated risk mitigation and evaluation strategy program. (va.gov)
  • Thus a re-challenge with clozapine of a patient who previously has experienced a clozapine-induced myocarditis or cardiomyopathy is strongly discouraged, as discussed in the review of Nielsen et al. (biomedcentral.com)
  • Another 99 patients who had discontinued treatment agreed to take clozapine (Clozaril), which is known to be more effective than other second-generation medications but carries a greater risk of side effects. (psychiatrictimes.com)
  • Further trials took place in 1972 when clozapine was released in Switzerland and Austria as Leponex. (wikipedia.org)
  • Underlying data for P, B, T and risk are from Leponex (clozapine) downloaded 2011-04-29. (janusinfo.se)
  • Constipation is a frequent and known side effect of clozapine, but serious and fatal events continue to be reported. (fda.gov)
  • An uncommon but serious side effect of clozapine is severe neutropenia, defined as an absolute neutrophil count (ANC) less than 500. (smiadviser.org)
  • We analysed the available information addressing: 1) clinical efficacy, 2) clinical predictors of outcome, 3) delay of action, 4) influence of clozapine on extrapyramidal symptomatology, 5) adverse effects and treatment withdrawal causes, 6) long-term follow-up data. (unboundmedicine.com)
  • However, the partially negative result of the only double-blind placebo-controlled trials, it may be stated that in some clinical situation of psychosis in PD, the use of clozapine may represent an opportune alternative when other therapeutic strategies have failed. (unboundmedicine.com)
  • Clinical improvements were seen more frequently in those taking clozapine (n=1119, 14 RCTs, RR 0.72 CI 0.7 to 0.8, NNT 6 CI 5 to 8). (qxmd.com)
  • However, clozapine patients experienced fewer motor adverse effects (n=1433, 18 RCTs, RR 0.58 CI 0.5 to 0.7, NNT 5 CI 4 to 6).The clinical effects of clozapine were more pronounced in participants resistant to typical neuroleptics in terms of clinical improvement (n=370, 4 RCTs, RR 0.71 CI 0.6 to 0.8, NNT 4 CI 3 to 6) and symptom reduction. (qxmd.com)
  • Thirty-four per cent of treatment-resistant participants had a clinical improvement with clozapine treatment. (qxmd.com)
  • The clinical effect of clozapine, however, is, at least in the short term, not reflected in measures of global functioning such as ability to leave the hospital and maintain an occupation. (qxmd.com)
  • Using a statistical learning approach to identify sociodemographic and clinical predictors of response to clozapine. (ox.ac.uk)
  • Knowledge of the sociodemographic and clinical factors predicting clozapine response may be useful in developing personalised approaches to treatment. (ox.ac.uk)
  • Using the Least Absolute Shrinkage and Selection Operator (LASSO) regression statistical learning approach, we examined 35 sociodemographic and clinical factors' predictive ability of response to clozapine at 3 months of treatment. (ox.ac.uk)
  • The average dose is significantly below the optimal therapeutic dosage recommended by clinical guidelines , and clozapine polytherapy is common. (bvsalud.org)
  • Clozapine is a psychiatric medication and is the first atypical antipsychotic (also called second-generation antipsychotic) to be discovered. (wikipedia.org)
  • Because of the risks with this medication, clozapine is available only through a special restricted distribution program. (medlineplus.gov)
  • Your doctor and your pharmacist must be registered with the Clozapine REMS program, and your pharmacist will not dispense your medication unless he or she has received the results of your blood tests. (medlineplus.gov)
  • Your doctor will probably start you on a low dose of clozapine and gradually increase your dose to give your body time to adjust to the medication and decrease the chance that you will experience this side effect. (medlineplus.gov)
  • Talk to the doctor who prescribed clozapine if you, a family member, or someone you care for has dementia and is taking this medication. (medlineplus.gov)
  • Forty-four percent of the clozapine patients continued to take the medication for the duration of the 18-month study, as did 29% of the patients receiving olanzapine. (psychiatrictimes.com)
  • Clozapine is an atypical antipsychotic medication first approved in the United States in 1989. (allenpress.com)
  • This medication is composed of active ingredient Clozapine. (thetopmedstore.com)
  • Clozapine online canadian pharmacy is one step closer to personally identifiable information and annual sales of medication counseling, will find out, provided by these companies thus far who suffer from or buy your approach requires more advantageous to provide solutions that facilitates the 1980s and has diminished in 9 december 19, they have resulted in these pharmacies were constantly in europe trip and the new medication, and honesty. (softballvalley.com)
  • On admission his medication consisted of 900 mg clozapine, 800 mg amisulpride and 10 mg flupenthixol. (biomedcentral.com)
  • 2 The mechanism of clozapine increasing the risk of pneumonia is likely multifactorial, related to a combination of reducing the defensive mechanisms against infection and aspiration. (psychiatrist.com)
  • The possible role oflithium in the mechanism of clozapine myelosuppression is discussed. (tau.ac.il)
  • The CPG lit review found that the quality and consistency of studies was variable, with only one RCT of moderate quality that compared clozapine to an alternative antipsychotic, olanzapine. (va.gov)
  • Of those patients, 49 received open-label treatment with clozapine and 50 were assigned blindly to olanzapine, quetiapine, or risperidone. (psychiatrictimes.com)
  • In the group that agreed to try clozapine, patients actually receiving clozapine continued longer than patients taking olanzapine, quetiapine, or risperidone. (psychiatrictimes.com)
  • In addition, the authors noted, 'at 3-month assessments, Positive and Negative Syndrome Scale total scores had decreased more in patients treated with clozapine than in patients treated with quetiapine or risperidone but not olanzapine. (psychiatrictimes.com)
  • Second: As a last resort, I bought these olanzapine clozapine structure for my daughter's life, but we enjoyed ourselves and finished using replacement parts which did NOTHING. (servicevents.fr)
  • Clozapine and olanzapine metabolism - he may be out of the barrel, but there's still a whiff of danger about him. (servicevents.fr)
  • As a fellow "repressed" (I prefer "goody two shoes"), I love the idea of trying out something olanzapine depot injection vs clozapine TOTALLY outside of my comfort zone. (servicevents.fr)
  • der Arzt erkennt das Problem, Mechanismus, mit dessen Hilfe propecia wirkt es (high-dose olanzapine versus clozapine) scheint, die fr die Behandlung von mnnlichen Typ. (servicevents.fr)
  • A program has been set up by the manufacturers of clozapine to be sure that people do not take clozapine without the necessary monitoring called the Clozapine Risk Evaluation and Mitigation Strategies (REMS) Program. (medlineplus.gov)
  • Clozapine is available only through a restricted program called the Clozapine REMS ( 5.2 ). (nih.gov)
  • In October 2015, the Food and Drug Administration (FDA) instituted an update to the mandatory Risk Evaluation and Mitigation Strategy (REMS) program for clozapine to improve safety monitoring of hematologic events. (allenpress.com)
  • However, the impact of the clozapine REMS program on reporting of hematologic adverse events has not been quantified. (allenpress.com)
  • We observed significant increases in reports of hematologic adverse events with clozapine after the introduction of the clozapine REMS program. (allenpress.com)
  • 3 However, due to the risk of serious adverse effects, e.g. significant constipation, blood dyscrasias, metabolic and cardiac toxicity, clozapine is limited to treatment-resistant patients and the initiating prescriber needs to ensure that careful monitoring occurs. (bpac.org.nz)
  • Clozapine is an antipsychotic drug, which is claimed to have superior efficacy and to cause fewer motor adverse effects than typical drugs for people with treatment-resistant illnesses. (qxmd.com)
  • RESULTS: We identified 242 service-users with a treatment-resistant psychotic disorder who had their first trial of clozapine and continued the treatment for at least 3 months. (ox.ac.uk)
  • Clozapine dosing ideally starts low and is slowly titrated upwards over three weeks to minimise adverse effects, usually to a daily maintenance dose of 300-450 mg. 7 Some patients may require higher doses, with a maximum daily dose of 900 mg. 7 A therapeutic response may take some time to develop, therefore 12 months of continuous treatment is recommended before deciding on the efficacy of clozapine. (bpac.org.nz)
  • However, although clozapine effectively delayed disease onset and reduced the severity of EAE, the therapeutic effect of clozapine was not associated with impaired capacity to induce antigen specific Th1 or Th17 responses in the periphery. (vuw.ac.nz)
  • This thesis demonstrated that clozapine treatment protects from EAE by a multi-faceted immunological mechanism that likely involves modifying multiple pathways and cell types during EAE and may be of therapeutic benefit to MS patients in the progressive stages of disease. (vuw.ac.nz)
  • Severe Neutropenia: Clozapine can cause severe neutropenia, which can lead to serious and fatal infections. (nih.gov)
  • The primary care team can improve safety through monitoring and management of constipation, neutropenia, metabolic effects and cardiac toxicity, and being aware of medicines which may interact with clozapine or exacerbate its adverse effects. (bpac.org.nz)
  • Patients taking clozapine should be monitored for symptoms and signs of cardiac toxicity and neutropenia. (bpac.org.nz)
  • Clozapine is relatively contraindicated in patients with severe cardiac or renal disorders, or a history of neutropenia, bone-marrow disorders, paralytic ileus, acute substance-induced psychosis or intoxication, circulatory collapse or epilepsy. (bpac.org.nz)
  • With required monitoring, clozapine is safe, and fatalities from neutropenia have been very rare. (smiadviser.org)
  • Talk to your doctor if you do not take clozapine for 2 days or longer. (medlineplus.gov)
  • Subsequently, immediate clozapine cessation led to normalizing inflammatory markers, including eosinophils, and his serum lipase improved to 163 U/L a week later. (psychiatrist.com)
  • Serum clozapine is 363 ng/mL. (mhaus.org)
  • The use of this drug can rarely result in clozapine-induced gastric hypomotility syndrome which may lead to bowel obstruction and death, and in older people with psychosis, as a result of dementia it may lead to an increased risk of death. (wikipedia.org)
  • Increased Mortality in Elderly Patients with Dementia-Related Psychosis: Clozapine is not approved for this condition. (nih.gov)
  • Scholz and Dichgans (1985) were the first to report the use of clozapine in drug-induced psychosis in PD. (unboundmedicine.com)
  • Numerous authors (23 articles) using case reports or open trials among more than 100 patients suggested that clozapine would be useful in treating drug-induced psychosis in PD. (unboundmedicine.com)
  • When used only in the short term, clozapine was superior for positive and negative symptoms, with higher baseline psychosis scores predicting better outcomes for clozapine. (medscape.com)
  • This cross-sectional study investigates clozapine prescription rates in a sample of 401 outpatients with psychosis from Bosnia and Herzegovina , Kosovo by United Nations resolution, North Macedonia , Montenegro and Serbia . (bvsalud.org)
  • The use of clozapine is associated with multiple improved outcomes, including a reduced rate of all-cause mortality, suicide and hospitalization. (wikipedia.org)
  • We found no significant difference in the effects of clozapine and typical neuroleptic drugs for broad outcomes such as mortality, ability to work or suitability for discharge at the end of the study. (qxmd.com)
  • The VigiBase search indicated major underreporting regarding clozapine and its fatal outcomes. (bvsalud.org)
  • By comparison, the United Kingdom had less than half the population of these Eastern European countries but reported to VigiBase more clozapine ADRs by 89-fold and clozapine fatal outcomes by almost 300-fold. (bvsalud.org)
  • Major improvement is needed in reporting clozapine ADRs and fatal outcomes in Eastern European countries. (bvsalud.org)
  • Taken as intended, Adderall and its counterparts can be a godsend for students with ADHD: clozapine medscape. (servicevents.fr)
  • next those that were on clozapine monotherapy were compared to those who were on clozapine polytherapy regime. (bvsalud.org)
  • Clozapine is known to be a highly effective antipsychotic agent and additionally provides a significant reduction in suicide-risk and aggression. (biomedcentral.com)
  • We report on the case of a 25 year-old patient, who was admitted for the evaluation of a potential electroconvulsive therapy due to persistent auditory hallucinations under clozapine. (biomedcentral.com)
  • Health care professionals should evaluate bowel function before starting a patient on clozapine and avoid co-prescribing clozapine with other anticholinergic medicines that can cause gastrointestinal hypomotility. (fda.gov)
  • 5 Clozapine has several black box warnings regarding potential severe adverse drug reactions (ADRs), including hematologic abnormalities. (allenpress.com)
  • Doubling clozapine use from the present 20% of patients to 40% would result in an additional 149 serious ADRs. (va.gov)
  • If only 20% started clozapine, there would be 3 deaths due to clozapine-related ADRs and 3 fewer suicides. (va.gov)
  • Reports of clozapine adverse drug reactions (ADRs) sent to the global pharmacovigilance database (VigiBase™) were analyzed from introduction to December 31, 2022. (bvsalud.org)
  • Severe gastrointestinal adverse reactions have occurred with the use of clozapine. (nih.gov)
  • Clozapine is also strongly associated with the risk of pneumonia, which is more severe during titration with accompanying high mortality. (psychiatrist.com)
  • Acute clozapine challenge (5-40 mg/kg i.p) produced dose-dependent increased extracellular levels of DA and its metabolites, 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA), in the medial prefrontal cortex of awake, free-moving rats as measured by in vivo brain microdialysis. (elsevierpure.com)
  • Acute clozapine challenge on day 22 in the chronic clozapine-treated animals produced no significant differences in medial prefrontal cortex, DA, DOPAC or HVA as compared to chronic vehicle-treated animals, indicating that tolerance to clozapine does not develop in the mesocortical DA system, in contrast to the mesolimbic system. (elsevierpure.com)
  • Patients initiating and continuing treatment with clozapine must have a baseline blood absolute neutrophil count (ANC) measured before treatment initiation and regular ANC monitoring during treatment ( 2.1 , 5.1 ). (nih.gov)
  • This effect is most pronounced in the first month after clozapine initiation. (psychiatrist.com)
  • 4-6 We present a unique case of concurrent pneumonia and pancreatitis following clozapine initiation and recurrence of pancreatitis upon rechallenge. (psychiatrist.com)
  • In addition, a clozapine order set was created to assist providers with initiation of clozapine. (allenpress.com)
  • All health professionals caring for patients taking clozapine should be aware that clozapine-induced constipation is highly prevalent, often difficult to detect and potentially fatal. (bpac.org.nz)
  • This condition, which occurs in about 0.8% of clozapine users, can be fatal. (kepalacinta.com)
  • More community-based long-term randomised trials are needed to evaluate the efficacy of clozapine on global and social functioning as trials in special groups such as people with learning disabilities. (qxmd.com)
  • Because clozapine is typically prescribed by psychiatrists, the distribution of psychiatrists by state was also analyzed. (smiadviser.org)
  • In a 2021 UK study, the majority of patients (over 85% of respondents) who took clozapine preferred it to their previous therapies, felt better on it and wanted to keep taking it. (wikipedia.org)
  • Une recherche documentaire a été effectuée dans PubMed de 1980 à 2021 en utilisant diverses combinaisons de termes MeSH comme tabac, diabète, hypertension, dyslipidémie, trouble dépressif majeur, trouble bipolaire, schizophrénie. (who.int)
  • Clozapine participants experienced more drowsiness, hypersalivation, or temperature increase, than those given conventional neuroleptics. (qxmd.com)
  • Clozapine in the treatment of aggression in an adolescent with autistic disorder. (bvsalud.org)
  • Clozapine-induced cardiomyopathy should be taken into account when monitoring patients treated with this antipsychotic and regular electrocardiograms should be performed in order to detect possible alterations as soon as possible. (biomedcentral.com)
  • This suggests that other factors are involved in its underuse in the U.S. 3 Some cite that besides the adverse effects and required monitoring, there is a lack of training of providers on the appropriate use of clozapine or perhaps a lack of understanding of its benefits. (allenpress.com)
  • In a 2013 network comparative meta-analysis of 15 antipsychotic drugs, clozapine was found to be significantly more effective than all other drugs. (wikipedia.org)
  • At admission, before the clozapine rechallenge, he was incidentally found to have a mildly elevated WCC of 16.6×10 9 /L and CRP of 2.3 mg/L with no signs of infection. (psychiatrist.com)
  • Clozapine has previously been found in purified wastewater in Stockholm County (2005-2012). (janusinfo.se)
  • They studied over 7,000 Medicaid patients regarding their antipsychotic use in 2009 and found that only 2% of antipsychotic prescriptions were for clozapine. (allenpress.com)
  • They also found that those hospitalized in state hospitals were more likely to be treated with clozapine compared to those in other settings. (allenpress.com)
  • We found clozapine to be more acceptable in long-term treatment than conventional antipsychotic drugs (n=982, 16 RCTs, RR 0.60 CI 0.5 to 0.7, NNT 15 CI 12 to 20). (qxmd.com)
  • The full protocol for blood cell monitoring with clozapine is found at https://www.newclozapinerems.com/home . (smiadviser.org)
  • Twenty-one papers with 25 comparison treatments were included, and the researchers found that clozapine was superior for treating positive symptoms in both the short and long term. (medscape.com)
  • Researchers at Karolinska Institutet in Sweden have found that the commonly used antipsychotic clozapine increases the risk of some cancers, including leukemia and lymphoma. (kepalacinta.com)
  • The researchers note that the idea that clozapine causes cancer is not new, as previous studies have also found this finding. (kepalacinta.com)
  • Consider prophylactic laxative treatment when starting clozapine in patients with a history of constipation or bowel obstruction. (fda.gov)
  • Buy clozapine bowel. (softballvalley.com)
  • Abbar M, Courtet P, Castelnau D. [Value of clozapine in treatment of psychotic disorder in Parkinson disease]. (unboundmedicine.com)
  • Clozapine is regarded as the gold-standard treatment when most other medications are ineffective and its use is recommended by multiple international treatment guidelines, after resistance to two other antipsychotic medications. (wikipedia.org)
  • Reporting odds ratios (ROR), proportional reporting ratios (PRR), and corresponding Taylor series 95% confidence intervals (CIs) were calculated for hematologic events with clozapine compared with all other medications using OpenEpi. (allenpress.com)
  • Clozapine patients also had higher overall Medicaid costs than those on other medications ($58,861 vs $16,687). (allenpress.com)
  • Our findings suggested that clozapine prescription rate in SEE outpatients is higher than in Western Europe . (bvsalud.org)
  • Prophylactic laxatives are recommended when clozapine is initiated and constipation should be considered at every consultation. (bpac.org.nz)
  • Pneumonia may be one of the more prevalent dangers of clozapine. (kepalacinta.com)
  • The LASSO regression identified three predictors of response to clozapine: higher severity of illness at baseline, female gender and having a comorbid mood disorder. (ox.ac.uk)
  • CONCLUSIONS: These findings suggest that women, people with a comorbid mood disorder and those who are most ill at baseline respond better to clozapine. (ox.ac.uk)
  • The risk is further increased at higher doses of clozapine and when it is co-prescribed with a type of medicine called anticholinergics, which can slow the movement in the intestines, and other medicines that cause constipation, including opioids. (fda.gov)
  • They used their expertise on the effects of ethnic ancestry in the stratification of clozapine dosing and the new idea that they published in March 2022 that African-Americans need higher clozapine doses because they have higher clozapine clearance. (bvsalud.org)
  • Clozapine may cause dizziness, lightheadedness, or fainting when you stand up, especially when you first start taking it or when your dose is increased. (medlineplus.gov)
  • RESULTS: In the first interaction on February 18, ChatGPT3 provided reasonable and very up-to-date information, which included a comment that patients of African ancestry have higher clozapine metabolism. (bvsalud.org)
  • Dr. Herbert Meltzer stated, "leading economists have cited the underuse of clozapine for treatment resistance and suicide as one of the two greatest failures of mental health providers to practice evidence-based medicine. (allenpress.com)
  • Deaths from clozapine-related adverse events are more than balanced out by decreased incidence of suicide attempts, with a net result of slightly fewer deaths with increased use of clozapine. (va.gov)
  • Clozapine comes as a tablet, an orally disintegrating tablet (tablet that dissolves quickly in the mouth), and an oral suspension (liquid) to take by mouth. (medlineplus.gov)
  • most of this has been covered at least one place or another in the forums, but clozapine tablet ip 50 mg I've decided to combine. (servicevents.fr)