Clozapine pharmacology and tardive dyskinesia.
Clozapine, an atypical neuroleptic, does not cause extrapyramidal symptoms of Parkinsonism and dystonia and appears to have a reduced or absent capacity to produce tardive dyskinesia. 37 subjects, most with chronic schizophrenia, were treated with clozapine and TD outcome was analyzed. A subset of these subjects underwent plasma and CSF studies. TD response was heterogenous, but a proportion of patients improved with clozapine treatment. Neurochemical data differed from published reports of classical neuroleptics with the most robust effect produced by clozapine seen in CSF norepinephrine levels. Other neurochemical data and implications for the mechanism of clozapine in TD are reviewed.
Lieberman
J
J
Hillside Hospital, Long Island Jewish Medical Center, Glen Oaks, NY 11004.
Johns
C
C
Cooper
T
T
Pollack
S
S
Kane
J
J
D000293:Adolescent; D000328:Adult; D003024:Clozapine / Q000009:adverse effects* / Q000627:therapeutic use; D003984:Dibenzazepines / Q000009:adverse effects*; D004409:Dyskinesia, Drug-Induced / Q000134:cerebrospinal fluid / Q000503:physiopathology*; D004837:Epinephrine / Q000134:cerebrospinal fluid; D005260:Female; D006719:Homovanillic Acid / Q000134:cerebrospinal fluid; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000134:cerebrospinal fluid; D008297:Male; D008734:Methoxyhydroxyphenylglycol / Q000134:cerebrospinal fluid; D009638:Norepinephrine / Q000134:cerebrospinal fluid; D010627:Phenethylamines / Q000134:cerebrospinal fluid; D011388:Prolactin / Q000097:blood; D012559:Schizophrenia / Q000188:drug therapy
D003984:Dibenzazepines; D010627:Phenethylamines; D008734:Methoxyhydroxyphenylglycol; D006897:Hydroxyindoleacetic Acid; D011388:Prolactin; D003024:Clozapine; D009638:Norepinephrine; D006719:Homovanillic Acid; D004837:Epinephrine