Clocapramine Explained

Clocapramine (Clofekton, Padrasen), also known as 3-chlorocarpipramine, is an atypical antipsychotic of the class which was introduced in Japan in 1974 by Yoshitomi for the treatment of schizophrenia.[1] [2] [3] [4] [5] In addition to psychosis, clocapramine has also been used to augment antidepressants in the treatment of anxiety and panic.[6]

Clocapramine has been reported to act as an antagonist of the D2, 5-HT2A, α1-adrenergic, and α2-adrenergic receptors, and does not inhibit the reuptake of either serotonin or norepinephrine.[4] [7] [8] [9] [10] It has also been shown to have affinity for SIGMAR1.[11] Clocapramine's affinity for the 5-HT2A receptor is greater than that for the D2 receptor and it has a lower propensity for inducing extrapyramidal symptoms compared to typical antipsychotics, thus underlying its atypical nature.[4] [5] [10]

Clinical trials

In several clinical trials, clocapramine has been compared to other neuroleptic agents. Against haloperidol, though there was no significant difference in efficacy at the end of the study, clocapramine tended to be superior in alleviating motor retardation, alogia, and thought disorder, and also produced fewer side effects.[12] Against sulpiride, clocapramine demonstrated more favorable effects in the treatment of both positive and negative symptoms, including motor retardation, delusions, hallucinations, and social isolation, though it produced more side effects.[13] Against timiperone, clocapramine showed lower efficacy against both positive and negative symptoms and produced more side effects such as dyskinesia, insomnia, constipation, and nausea.[14]

Clocapramine has been implicated in at least one fatality, a suicide in which there were two self-inflicted stab wounds and an overdose of clocapramine as well as three other antipsychotics was taken.[15] The stab wounds could not explain the death, and thus, it was attributed to multiple drug toxicity instead.[15]

See also

Notes and References

  1. Book: David J. Triggle . Dictionary of pharmacological agents . Chapman & Hall . London . 1997 . 978-0-412-46630-4 .
  2. Book: Swiss Pharmaceutical Society . Index Nominum 2000: International Drug Directory (Book with CD-ROM) . Medpharm Scientific Publishers . Boca Raton . 2000 . 1932 . 978-3-88763-075-1 .
  3. Book: Sittig, Marshall . Pharmaceutical manufacturing encyclopedia . Noyes Publications . Park Ridge, N.J., U.S.A . 1988 . 1756 . 978-0-8155-1144-1 . registration . clocapramine. .
  4. Sumiyoshi T, Suzuki K, Sakamoto H . Atypicality of several antipsychotics on the basis of in vivo dopamine-D2 and serotonin-5HT2 receptor occupancy . Neuropsychopharmacology . 12 . 1 . 57–64 . February 1995 . 7766287 . 10.1016/0893-133X(94)00064-7 . etal.
  5. Oka T, Hamamura T, Lee Y . Atypical properties of several classes of antipsychotic drugs on the basis of differential induction of Fos-like immunoreactivity in the rat brain . Life Sciences . 76 . 2 . 225–37 . November 2004 . 15519367 . 10.1016/j.lfs.2004.08.009 . etal.
  6. Saito M, Miyaoka H . Augmentation of paroxetine with clocapramine in panic disorder . Psychiatry and Clinical Neurosciences . 61 . 4 . 449 . August 2007 . 17610675 . 10.1111/j.1440-1819.2007.01690.x . 38739899 . free .
  7. Kurihara M, Tsumagari T, Setoguchi M, Fukuda T . A study on the pharmacological and biochemical profile of clocapramine . International Pharmacopsychiatry . 17 . 2 . 73–90 . 1982 . 6125486 . 10.1159/000468561.
  8. Tsukamoto T, Asakura M, Hirata N, Imafuku J, Matsui H, Hasegawa K . Interaction of neuroleptics and antidepressants with rat brain alpha 2-receptors: a possible relationship between alpha 2-receptor antagonism and antidepressant action . Biological Psychiatry . 19 . 9 . 1283–91 . September 1984 . 6149771 .
  9. Setoguchi M, Sakamori M, Takehara S, Fukuda T . Effects of iminodibenzyl antipsychotic drugs on cerebral dopamine and alpha-adrenergic receptors . European Journal of Pharmacology . 112 . 3 . 313–22 . June 1985 . 2862053 . 10.1016/0014-2999(85)90776-9.
  10. Schotte A, Bonaventure P, Janssen PF, Leysen JE . In vitro receptor binding and in vivo receptor occupancy in rat and guinea pig brain: risperidone compared with antipsychotics hitherto used . Japanese Journal of Pharmacology . 69 . 4 . 399–412 . December 1995 . 8786644 . 10.1254/jjp.69.399. free .
  11. Morio Y, Tanimoto H, Yakushiji T, Morimoto Y . Characterization of the currents induced by sigma ligands in NCB20 neuroblastoma cells . Brain Research . 637 . 1–2 . 190–6 . February 1994 . 7910100 . 10.1016/0006-8993(94)91232-7. 19250949 .
  12. Yamagami S . A crossover study of clocapramine and haloperidol in chronic schizophrenia . The Journal of International Medical Research . 13 . 6 . 301–10 . 1985 . 4076529 . 10.1177/030006058501300601. 16157745 .
  13. Yamagami S, Kiriike N, Kawaguchi K . A single-blind study of clocapramine and sulpiride in hospitalized chronic schizophrenic patients . Drugs Under Experimental and Clinical Research . 14 . 11 . 707–13 . 1988 . 3246215 .
  14. Nakazawa T, Ohara K, Sawa Y . Comparison of efficacy of timiperone, a new butyrophenone derivative, and clocapramine in schizophrenia: a multiclinic double-blind study . The Journal of International Medical Research . 11 . 5 . 247–58 . 1983 . 6139317 . 10.1177/030006058301100501. 25624985 . etal.
  15. Koreeda A, Yonemitsu K, Ng'walali PM, Muraoka N, Tsunenari S . Clocapramine-related fatality. Postmortem drug levels in multiple psychoactive drug poisoning . Forensic Science International . 122 . 1 . 48–51 . October 2001 . 11587865 . 10.1016/S0379-0738(01)00442-X.

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