Clocapramine

What is clocapramine?

Second generation antipsychotics (sometimes referred to as ‘atypical’ antipsychotics) such as clocapramine are a newer class of antipsychotic medication than first generation ‘typical’ antipsychotics. Second generation antipsychotics are effective for the positive symptoms of schizophrenia. It is sometimes claimed that they are more effective than first generation antipsychotics in treating the negative symptoms of schizophrenia, although the evidence for this is weak. Negative symptoms include a lack of ordinary mental activities such as emotional expression, social engagement, thinking and motivation, whereas positive symptoms include the experiences of perceptual abnormalities (hallucinations) and fixed, false, irrational beliefs (delusions). Second generation antipsychotics may also cause less extra-pyramidal side effects. These include dyskinesias such as repetitive, involuntary, and purposeless body or facial movements, Parkinsonism (cogwheel muscle rigidity, pill-rolling tremor and reduced or slowed movements), akathisia (motor restlessness, especially in the legs, and resembling agitation) and dystonias such as muscle contractions causing unusual twisting of parts of the body, most often in the neck. These effects are caused by the dopamine receptor antagonist action of these drugs.

What is the evidence for clocapramine?

Moderate quality evidence suggests no differences between clocapramine and first or second generation antipsychotics for discontinuation or response, although in comparison with second generation antipsychotics only, clocapramine may be less effective. There was less incidence of headaches and decreased appetite with clocapramine.

November 2019

Last updated at: 12:47 am, 22nd November 2019
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