What is mosapramine?

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

High quality evidence suggests greater improvement in positive symptoms, but not other symptoms, with mosapramine than with second generation antipsychotics aripiprazole, perospirone, or quetiapine. However, there are more extrapyramidal or movement symptoms, and increased salivation with mosaprimine than with first generation antipsychotics haloperidol, or second generation antipsychotics clocapramine, aripiprazole, perospirone, or quetiapine. There is also a greater risk of higher prolactin levels with mosapramine than with aripiprazole, perospirone, or quetiapine.

October 2020

Last updated at: 4:40 am, 14th October 2020
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