Zotepine

Zotepine (Nipolept, Losizopilon, Lodopin) is an atypical antipsychotic indicated for acute and chronic schizophrenia. It has been used in Germany since 1990 and Japan since 1982.

The most common dosage used is 150mg daily. It is suggested that zotepine therapy starts at 75mg to 150mg divided into three daily doses. Some people may need to have their dosage increased to 300mg.

Pharmacology
The antipsychotic effect of zotepine is thought to be mediated through antagonist activity at dopamine and serotonin receptors. Zotepine has a high affinity for the dopamine D1 and D2 recepetors. It also affects the 5HT2a, 5HT2c, 5HT6, and 5HT7 receptors. In addition, it inhibits the reuptake of noradrenaline. It is thought that this is why zotepine has a high efficacy for the negative symptoms of schizophrenia.

Side effects
The most common side effect of Zotepine is weight gain. This weight gain side effect compares badly to the older typical antipsychotics. Somnolence is the second most common side effect. Constipation, asthenia, dry mouth, and akathisia are also reported.

The likelihood of side effects are as follows:

Weight gain: Medium to high Hyperprolactinemia: high Sexual problems: high Sedation: high EPSE's (Assumes that normal doses are used but may vary with the dose given):Low Hypotension: Medium Hyperglycaemia: Low