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What is clotiapine?

Second generation antipsychotics (sometimes referred to as ‘atypical’ antipsychotics) such as clotiapine 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 extrapyramidal 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 clotiapine?

Moderate to low quality evidence finds no differences in global state or hospital discharge rates between clotiapine and first generation antipsychotics (chlorpromazine, perphenazine, trifluoperazine or zuclopenthixol acetate). Lower quality evidence suggests clotiapine may induce fewer parkinsonian symptoms than first generation antipsychotics. Low quality evidence is unable to determine any benefit or harm of chlorpromazine or benzodiazapines over clotiapine.

October 2020

Last updated at: 4:34 am, 14th October 2020
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Fact Sheet Technical Commentary

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Title Colour Legend:
Green - Topic summary is available.
Orange - Topic summary is being compiled.
Red - Topic summary has no current systematic review available.