Depression Symptoms Treatment

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Clozapine is authorised in the world under the following brand names: Asaleptin, Clozaril, Fazaclo ODT, Iprox, Leponex, Lepotex.

There a two major classes of agents currently used to treat schizophrenia – the older neuroleptics (typical antipsychotics) and the newer atypical antipsychotics such as clozapine, olanzapine (Zyprexa) and risperidone (Risperdal). The first class of agents is comprised of predominantly dopamine-2 (D₂) receptor antagonists, with haloperidol being the prototype. These neuroleptics have little, if any, direct effects on serotonin systems; e.g., haloperidol does not interact appreciably with serotonin-2 (5-HT₂) receptors. This is in marked contrast to most of the atypical agents in current use, which generally have lower D₂ and higher 5-HT_2A pKi values (a logarithmic measure of drug affinity for a receptor).

In essence, the currently available atypicals are “5-HT₂/D₂” antagonists, although several of them (e.g., clozapine and olanzapine) affect a variety of other receptor areas. Clozapine appears to have affinity for both 5-HT_2C and 5-HT_2A receptors. Differing from both these types of agents is a group of drugs known as selective 5-HT_2A antagonists. Although they differ as to their specificity for 5-HT₂ receptor subtypes, this group of agents shares the property of having essentially no dopamine receptor blockade.

Setoperone, ritanserin, mianserin, ketanserin and the investigational agent M100907 are all in this class, however, pharmacodynamic differences exist among them; e.g., ritanserin antagonizes both 5-HT_2A and 5-HT_2C receptors, whereas M100907 is a pure 5-HT_2A antagonist. There is growing evidence that the antiserotonergic effects of these and currently available atypical agents contribute to improved efficacy and safety in the treatment of schizophrenia.