Other Atypical Antipsychotics (Wiki)

Atypical Antipsychotics that do not fall neatley into any of the other categories.


Clotiapine/Cothiapine (WIki)

Brand names: None known
Formula: C18H18ClN3S
Half life: Unknown
Single unit dose: 40mg per day [Verified]
Recommended outpatient does: 40mg per day [Verified]
Maximum outpatient dose: Unknown

I know nothing about this drug at this time except that the infant dose is typically about 20mg per day.

Clozapine (Wiki)

Brand names: Clozaril®, Denzapine®, Fazaclo®, Froidir®, Gen-Clozapine®, Klozapol®, Zaponex®
Formula: C18H19N4Cl
Half life: ~ 14.2 hours
Single unit dose: 100mg per day
Recommended outpatient dose: 300mg per day [Verified]
Maximum outpatient dose: 900mg per day [Verified]

The first atypical antipsychotic to be developed, clozapine started out life as a heavy duty antidepressant but was noted to also have a positive effect on psychotic disorders. Introduced in 1971, the drug was withdrawn from the market four years later, following a number of fatal cases of agranulocytosis under clozapine therapy. The drug disappeared from psychiatric circles for many years but was reintroduced when studies showed clozapine to be more effective in the treatment of psychosis than virtually every other antipsychotic available (including at the time of writing); it was especially useful in the treatment of treatment resistant psychosis. Subsequent uses include the treatment of chronically suicidal patients and as a treatment for tardive dyskinesia.

The drug is sedative and will almost certainly cause patients to gain weight; typical side effects include a lowered threshold for seizures in general, drooling, constipation, tremor and muscle stiffness amongst others.

Clozapine is not widely prescribed to patients indeed, it is a rare drug to be given. The reason for this is the chance of potentially fatal side effects (such as agranulocytosis, whose incident rate is 1% during the first 6 months of therapy and 0.01% from then on) that demand regular blood tests and close monitoring during therapy. As a result, the dosage should be started off very gradually, steadily building up in increments of not more than 25mg a night to the target dose.

Although clozapine is referred to as an atypical antipsychotic, such a label is a drastic understatement; many consider the drug to be in a class of its own.

Iloperidone (Wiki)

Brand names: Fanapt®, Fanapta®, Zomaril®
Formula: C24H27FN2O4
Half life: ~ 18 - 33 hours
Single unit dose: 8mg per day
Recommended outpatient dose: 8mg per day [Verified]
Maximum outpatient dose: 32mg per day [Verified]

Effective in doses as low as 5mg, this new antipsychotic was approved for use in the United States on May 6, 2009. Like all atypical antipsychotics, it acts on dopamine and serotonin receptors. Patients should ingest the drug alongside food to minimise the incidence rates of side effects. A special injection form of the drug, which can be administrated every four weeks, is under research.

Loxapine (Wiki)

Brand names: Loxapac®, Loxitane®
Formula: C18H18ClNO3
Half life: ~ 4 hours
Single unit dose: Unknown
Recommended outpatient dose: 60mg per day [Highly Questionable]
Maximum outpatient dose: 250mg per day [Verified]

Although mostly classified as a typical antipsychotic, many researchers believe that loxapine might in fact be atypical in nature.

Olanzapine (Wiki)

Brand names: Olzapin®, Zalasta®, Zolafren®, Zydis®, Zyprexa®, Zyprexa Zydis®
Formula: C17H20N4S
Half life: ~ 30 hours
Single unit dose: 2.5mg per day
Recommended outpatient dose: 10mg per day [Verified]
Maximum outpatient dose: 30mg per day [Verified]

The second atypical antipsychotic to be released, olanzapine is often referred to as the chemical kosche due to its sedative and tranquillising properties; it is structurally similar to the drug clozapine, of the same class.

Generally speaking, olanzapine is a highly regarded drug - it's generally well tolerated, is largely effective and has relatively few serious problems associated with it; as such, it is one of the most widely prescribed drugs of its class. The drug also possesses antidepressant qualities and is often mixed with the SSRI antidepressant fluoxetine to produce a substance marketed as Symbyax®.

Unfortunately, olanzapine will probably cause weight gain and (as was previously mentioned) will almost certainly cause drowsiness as well.

Quetiapine (Wiki)

Brand names: Ketipinor®, Seroquel®
Formula: C21H25N3O2S
Half life: ~ 6 hours
Single unit dose: 100mg per day
Recommended outpatient dose: 300mg per day [Verified]
Maximum outpatient dose: 800mg per day [Verified]

Generally regarded as the most soft of all the antipsychotics (typical or atypical), quetiapine is strongly sedative and takes a fair while to present positive effects on the patients state of mind. The drug also sports a great ability to be upped in dosage very quickly compared to other drugs of the same class. It is often used as a long term treatment for insomnia and is intended as a treatment for depressive disorders (due to a decent antidepressive effect) and for anxiety disorders.