Clozapine Haloperidol

Antipsychotics Reduce hallucinations and delusions Chlorpromazine, haloperidol, clozapine... 

Antidepressants tricyclics, fluoxetine, paroxetine, sertraline, mirtazepine, venlafaxine, mianserin Antipsychotics phenothiazines, haloperidol, clozapine, olanzapine, quetiapine... 

In most cases, SSRIs are the first choice for drugs to combat OCD. Clomipramine, fluvoxamine, fluoxetine, paroxetine, sertraline, and citalopram are all SSRIs that have been proven effective in reducing OCD symptoms. However, in about 40 to 60% of patients, these drugs do not completely alleviate all the symptoms. When this is the case, a second type of drug called a neuroleptic is often added. Neuroleptic drugs, such as haloperidol, clozapine, risperidone, and chlorpromazine... 

P450 IID6 -fin women Inhibited by OCs Hydroxylation of nortriptyline and desipramine, haloperidol, clozapine, risperidone, venlafaxine Fluoxetine, fluvoxamine, paroxetine, sertraline... 

Another use of the laboratory is for therapeutic drug monitoring (TDM) of psychotropics with defined optimal ranges, narrow therapeutic indices, or both. Although TDM is not essential for many psychotropics, it is for others, including lithium, several TCAs, valproate, and carbamazepine. It may also be helpful to optimize the use of certain antipsychotics (e.g., haloperidol, clozapine) ( 7). 

Therapeutic Efficacy. Early evidence supporting clozapine s efficacy came from one double-blind, placebo-controlled study and six other neuroleptic-controlled, random-assignment studies (43, 57, 58, 59 and 60 Novartis, unpublished data). When compared with neuroleptics such as CPZ and haloperidol, clozapine was found to be more effective (i.e., three studies found clozapine significantly superior and two others found a trend favoring clozapine ( p = 0.10)). When the results of these studies were combined, the probability that clozapine is superior to neuroleptic antipsychotics was highly statistically significant ( p = 1 x 1CT °) (Table 5-11 and Table 5-12). 

Jarskog et al. (2007) studied the effects of haloperidol, clozapine, and quetiapine on numerous so-called apoptotic markers to study the impact of these drugs on apoptosis. Essentially, they examined the neurotoxicity of neuroleptics, specifically their capacity to induce cell deterioration typical of the process of cell death. They found that the neuroleptics, both the older ones and the atypicals, caused activation of caspase-3, a marker for apoptosis. They tried to reassure their readers that this activity was probably non-lethal. ... 

Gessa GL, Devoto P, Diana M, Flore G, Melis M, et al. 2000. Dissociation of haloperidol, clozapine, and olanzapine effects on electrical activity of mesocortical dopamine neurons and dopamine release in the prefrontal cortex. Neuropsychopharmacology 22 642-649. 

Nguyen TV, Kosofsky BE, Birnbaum R, Cohen BM, Hyman SE (1992) Differential expression of c-fos and zif268 in rat striatum after haloperidol, clozapine, and amphetamine. Proc Natl Acad Sci USA 9 4270 1274. 

Figure 10.4 Radar plots of csp for haloperidol, clozapine, tiospirone, and yohimbine interactions with each of the seven TM regions in amine GPCRs.

ARIPIPRAZOLE, HALOPERIDOL, CLOZAPINE, PIMOZIDE, RISPERIDONE, SERTINDOLE PROTEASE INHIBITORS Possibly T levels of antipsychotic Inhibition of CYP3A4- and/or CYP2D6-mediated metabolism Avoid co-administration of clozapine with ritonavir, and pimozide or sertindole with protease inhibitors. Use other antipsychotics with caution as 1 dose may be required with risperidone, watch closely for extrapyramidal side-effects and neuroepileptic malignant syndrome... 

Antidepressants mirtazapine, nefazodone, sertraline Neuroleptics thioridazine, haloperidol, clozapine, quetiapine, risperidone, sertindole, ziprasidone Mood stabilizers carbamazepine, gabapentin, lamotrigine... 

Amphetamine disrupts the LI response in rats (170,171), and this is reversed by haloper idol, clozapine, and sertindole (172,173) and the 5-HT2A antagonist MDL 100,907 (174). The 5-HT, agonist DOI, when administered -in the pre-exposure phase only, disrupts LI and this disruption is prevented by haloperidol, clozapine, risperidone, and MDL 100,907 (175). This disruption could be because of effects of DOI on state-dependent learning rather than on attentional processes (175). 

Full agonists morphine, meperidine, methadone, fentanyl, and heroin Partial agonists buprenorphine, codeine, propoxyphene Mixed agonist-antagonists nalbuphine, pentazocine Antagonists naloxone, naltrexone Phenothiazines chlorpromazine, fluphenazine, thioridazine Others haloperidol, clozapine, risperidone, olanzapine... 

Dopamine receptors (D, D, D ) Antipsychotics (e.g., haloperidol, clozapine, thioridazine, nemonapride) Antipsychotic response (D, Dj, D ), antipsychotic-induced tardive dyskinesia (Dj) and acute akathisia (Dj), hyperprolactinemia in females (D )... 

Blood levels clearly correlate with therapeutic response for a minority of the psychotropic drugs, including the antipsychotics haloperidol, clozapine, and olanzapine the tricyclic antidepressants and the mood stabilizer lithium. 

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