Clozapine is a type of medicine known as atypical antipsychotic. Clozapine works in the brain, where it affects a neurotransmitter called dopamine. Neurotransmitters are chemicals stored in nerve cells, and are involved in transmitting messages between the nerve cells.
The introduction of Clozapine, marked a turning point in the treatment of schizophrenia, as the first "atypical" antipsychotic drug lacking the propensity to produce ‘extra-pyramidal symptoms’ (associated with the older antipsychotic agents) (Kane et al. 1988). Even though, Clozapine has not conclusively demonstrated its significantly superior record or efficacy for psychosis (Gardner et al. 2005), it has proven exceptional effectiveness, compared to other more traditional antipsychotics (Claghorn et al. 1987). However, Kane et al. (1988) and others have concluded, 30–60% of all schizophrenic patients who fail to respond to typical antipsychotics may respond therapeutically/effectively to Clozapine (Breier et al. (1994) & Iqbal et al. (2003)). This is especially apparent for refractory schizophrenia (Kane et al. 1988), treatment-resistant schizoaffective disorders (Zarate et al. 1995) and aggression (Cohen & Underwood, 1994).
The linkage of serotonin to depression has been known for the past five years. From numerous studies, the most concrete evidence of this connection is the decreased concentration of serotonin metabolites like 5-HIAA (5-hydroxyindole acetic acid) in the cerebrospinal fluid and brain tissues of depressed people. If depression, as suggested, is a result of decreased levels of serotonin in the brain, pharmaceutical agents that can reverse this effect should be helpful in treating depressed patients. Therefore, the primary targets of various antidepressant medications are serotonin transports of the brain. Since serotonin is activated when released by neurons into the synapse, antidepressants function at the synapse to enhance serotonin activity. Normally, serotonin's actions in the synapse are terminated by its being taken back into the neuron then releases it at which point "it is either recycled for reuse as a transmitter or broken down into its metabolic by products and transported out of the brain." As a result, antidepressants work to increase serotonin levels at the synapse by blocking serotonin reuptake (2).
Diamond in chapters 4, 7 and 9, looks at antipsychotic medications, medications useful for anxiety disorders and sleep problems and medication for people with borderline personality disorder respectively. Antipsychotic medications are profiled as second generation or first generation. Among the identified second generation antipsychotic medications are clozapine, risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole and paliperidone. Clozapine is considered tpo be the most effective antipsychotic drug and has been proven effective as a mood stabilizer in treating “bipolar disorders that have not responded to mood stabilizers” (p. 72). Clozapine has side effects including those of weight gain, metabolic syndrome and increased risk
Antipsychotics: Olanzapine (Zyprexa), Risperidone (Risperdal), Quetiapine (Seroquel), Ariprazoe (Abilify), Ziprasidone (Geodon), Lurasidone (Latuda), Asenapine (Saphris)
Other clinical studies have implicated fluoxetine’s effects on serotonin neurotransmitters, based on the fact that serotonin is synthesized from the essential amino acid tryptophan. Patients taking fluoxetine who were in remission from major depression were given a special diet which was tryptophan-free. This rapidly decreased plasma serotonin levels, and after a short period of time (as little as 30 minutes) many of the patients began to have signs of specific depressive symptoms. Later, the reappearance of more general depressive symptoms were observed in a majority of the patients. Thus it was shown that fluoxetine has a profound effect on the neurotransmitter serotonin, and decreased
A comparison between schizophrenia and bipolar spectrum disorder focusing on history, etiology, treatment, and symptoms of each disease will introduce the concept of the Continuum Disease Model (CDM) as a basis for further debate and discussion on the controversial designation of schizoaffective disorder (bipolar type/depressive type). The concept of a possible connection between distinct disorders is strongly disputed between many experts due to presence of manic or hypomanic episodes as a clear distinction requiring the designation of bipolar spectrum disorder as opposed to negative and positive schizophrenic symptoms; however, similarities in the disorders including etiology, presence of psychosis, and effectiveness of new atypical antipsychotic treatments may present similar neurological psychopathology. Schizoaffective disorder may present only unipolar depressive symptoms along with negative or positive schizophrenic symptoms but bipolar type will be the focus of discussion. An argument disputing the legitimacy of the CDM will be presented though the stress-diathesis model supports the designation of schizoaffective disorder in the newest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). A deeper look at the mechanisms in the psychopharmacological drug treatments specifically focused on the atypical antipsychotics quetiapine (trade name Seroquel) and lurasidone (trade name Latuda), providing theories of their effects on brain
Antipsychotics are medications that physicians use to treat psychotic disorders such as Schizophrenia, Delusional disorder, Paraphrenia, and Substance-induced psychotic disorders. These disorders are characterised by the patient’s inability to make good judgments, think with a clear head, communicate effectively, relate to society, and understand reality. Antipsychotic drugs are also useful in the treatment of bipolar conditions that involve extreme cases of manic behaviour. Examples of these drugs include Thorazine and Trilafon. These drugs belong to a drug class called phenothiazines. They work by changing the actions of chemicals in the brain. The drugs can be beneficial, however, Steen et al. (2014) argue that the medicines have several harmful effects such as changes
Antipsychotics are generally used to treat psychosis in mental disorders. These disorders include schizophrenia and bipolar disorder (Thyssen et al., 2010). Risperidone is known as an atypical second generation antipsychotic and used in the treatment of a multitude of disorders. This medication can often challenge behavioral problems that are associated with schizophrenia, autism spectrum disorder, bipolar disorder, or attention deficit hyperactivity disorder (Schatzberg & Nemeroff, 2013). It is important for the prescriber to be aware of the side effect and any possible adverse reactions that may occur. There can be many detrimental side effects that someone may not enjoy,
Antipsychotic medications are proven to help in treating acute psychosis and to reduce the risk of future psychotic events. People with severe symptoms require hospitalization to ensure safety, proper nutrition, adequate sleep, and proper hygiene. Some common medication used to treat schizophrenia are, trifluoperazine, flupenthixol, loxapine among others. There is a side effect from every medication we take, and there is no exception for antipsychotic medications. These medications may cause, drowsiness, dizziness, blurred vision, rapid heartbeat, sensitivity to the sun, rashes, and menstrual problems for women. People taking these medications should not operate machinery or drive a car until they adjust to all of their medications. However, people might need to try several medications until they find the appropriate medication for them. People should not stop taking any medication without the proper recommendation from their doctor. Not taking their medication adequately may cause a relapse and the symptoms come back or usually their symptoms get
Perry, P. J., Alexander, B., Liskow, B. I., & DeVane, C. L. (2007). Psychotropic drug handbook (8th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
People with the disease may exhibit irritability, anxiety, and depression in the early stages. In later stages they may exhibit agitation, anger, aggression, hallucinations, restlessness, verbal or physical outburst, and delusions. Medications given are antidepressants such as; citalopram, fluoxetine, paroxeine, sertraline and trazodone. For anxiety, restlessness and verbal behavior anxiolytics are given such as; lorazepam and oxazepam. Antipsychotics that may be given are; aripiprazole, clozapine, haloperidol, olanzapine, quetiapine, risperidone and ziprasidone. The use of antipsychotics should be seriously weighed for the risk of stroke and
Möller (1999) has critically examined and analyzed the effectiveness, risk, and safety measures of using benzodiazepine that is consistent with Batelaan, Van Balkom & Stein (2012) idea. Moller (1999) argues that as much as benzodiazepine has many survival values, the drug is crammed with notable side effects and risks that can jeopardize the health of the patient. The author presented traceable basic pharmacotherapy of benzodiazepines that has played an imperative role in accounting the side effects of it. In addition, the author has provided pharmacological properties of benzodiazepines and linked the properties with side effects and potential risks. The author has analyzed the clinical indications and
Perry, P. J., Alexander, B., Liskow, B. I., & DeVane, C. L. (2007). Psychotropic drug handbook (8th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Enhance the affinity of the recognition site for GABA by inducing conformational changes that make GABA binding more efficacious.