Clotiapine Explained
Clotiapine (Entumine) is an atypical antipsychotic[1] of the dibenzothiazepine chemical class.[2] It was first introduced in a few European countries (namely, Belgium, Italy, Spain and Switzerland), Argentina, Taiwan and Israel in 1970.
Some sources regard clotiapine as a typical antipsychotic rather than atypical due to its high incidence of extrapyramidal side effects compared to the atypicals like clozapine and quetiapine, to which it is structurally related.[3] Despite the relativity high rate of undesired effects it has demonstrated efficacy in treatment-resistant individuals with schizophrenia according to a number of psychiatrists with clinical experience with it, some weak clinical evidence supports this view too.[4] [3] [5] A systematic review performed by Cochrane compared clotiapine with other antipsychotic drugs:
Clotiapine compared to other antipsychotic drugs for acute psychotic illnesses[6] | Summary |
|---|
| There was no evidence to support or refute the use of clotiapine in preference to other antipsychotic drug treatments for management of people with acute psychotic illness. |
| Outcome | Findings in words | Findings in numbers | Quality of evidence |
|---|
| General clinical impression |
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| No significant improvement | There is no clear difference between people given clotiapine and those receiving other antipsychotic drugs for acute psychotic illnesses. These findings are based on data of low quality. | RR 0.88 (0.39 to 1.98) | Low | | Not well enough to be discharged | Clotiapine is not clearly different to other antipsychotic drugs for this outcome - for people who are acutely unwell. These findings are based on data of low quality. | RR 1.04 (0.93 to 1.16) | Low | | Adverse effects |
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| Movement disorders - use of antiparkinsonian medication | Clotiapine may reduce the use of antiparkinsonian drugs - implying that clotiapine causes less of this effect, but, at present it is not possible to be confident about the difference between the two treatments and data supporting this finding are very limited. | RR 0.43 (0.05 to 3.53) | Very low | | Seizure | Clotiapine may increase the risk of fits, but, the difference between the two treatments is not clear. This finding is based on data of low quality. | RR 3.67 (0.16 to 84.66) | Low | | Satisfaction with care |
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| Leaving the study early - any reason | There is no clear difference between people given clotiapine and those receiving other antipsychotics for acute psychotic illnesses. These findings are based on data of low quality. | RR 2.09 (0.81 to 5.42) | Low | | No study reported any data on outcomes as sedation and information relating to behavioral outcomes such as tranquillisation. | | Clotiapine increases very fast weight, like approximately in 6 or 7 days of the start, so it is convenient to speak with your doctor it this happens. | |
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A fatal case of urinary retention associated with this drug has been reported in literature.[7]
Notes and References
- Seminara G, Trassari V, Prestifilippo N, Chiavetta R, Calandra C . [Atypical tricyclic neuroleptics for treatment of schizophrenia. Clothiapine and clozapine] . Minerva Psichiatrica . 34 . 2 . 95–99 . June 1993 . 8105359 .
- Schmutz J, Künzle F, Hunziker F, Gauch R . Über in 11-Stellung amino-substituierte Dibenzo[b,f]-1, 4-thiazepine und -oxazepine. 9. Mitteilung über siebengliedrige Heterocyclen . 10.1002/hlca.19670500131 . Helvetica Chimica Acta . 50 . 245–254 . 1967 .
- Geller V, Gorzaltsan I, Shleifer T, Belmaker RH, Bersudsky Y . Clotiapine compared with chlorpromazine in chronic schizophrenia . Schizophrenia Research . 80 . 2–3 . 343–347 . December 2005 . 16126373 . 10.1016/j.schres.2005.07.007 . 22340010 .
- Clotiapine: Another forgotten treasure in psychiatry?. European Neuropsychopharmacology. 7. Suppl 2. S217. 10.1016/S0924-977X(97)88712-3. September 1997. Lokshin P, Kotler M, Belmaker RH . 54246576 .
- Van Wyk AJ, Marais GF . Chlorpromazine, clotiapine and thioridazine--a comparative clinical trial on Bantu psychotic patients . South African Medical Journal = Suid-Afrikaanse Tydskrif vir Geneeskunde . 45 . 34 . 945–947 . August 1971 . 4939661 .
- Carpenter S, Berk M, Rathbone J . Clotiapine for acute psychotic illnesses . The Cochrane Database of Systematic Reviews . 2004 . 4 . CD002304 . October 2004 . 15495032 . 8985500 . 10.1002/14651858.CD002304.pub2 .
- Mannocchi G, Pantano F, Tittarelli R, Catanese M, Umani Ronchi F, Busardò FP (2015) Development and Validation of a GC-MS Method for the Detection and Quantification of Clotiapine in Blood and Urine Specimens and Application to a Postmortem Case. Int J Anal Chem 2015 :972480. DOI:10.1155/2015/972480 PMID: 26236337
