Zotepine is a neuroleptic drug categorized as an atypical antipsychotic, used in some countries for the treatment of schizophrenia. As of 2011, this medication was available for consumer use in countries including Japan, Germany, Taiwan, and Indonesia but was not approved by the Food and Drug Administration (FDA) for use in the United States. The use of this medicine has been discontinued in the United Kingdom.
It is believed that zotepine affects certain neurotransmitters in the brain, specifically serotonin and dopamine, that regulate behavior and mood. Some symptoms of schizophrenia, such as hallucinations and delusions, are associated with an overabundance of dopamine. Zotepine acts to block dopamine receptors in order to control schizophrenia symptoms.
This drug is said to be unusual in its effectiveness at reducing so-called negative symptoms of schizophrenia. Such symptoms can include self-isolation from others as well as an appearance of emotionlessness. In contrast, some antipsychotic medicines seem to primarily influence positive symptoms such as hostile behavior, hallucinations, and thought disturbances.
Drowsiness is a common side effect of zotepine use. For this reason, individuals using this medication are urged to avoid drinking alcohol, which can dangerously intensify the sleepiness caused by zotepine. Individuals should also use caution in operating machinery or motor vehicles. Some people might experience a rapid drop in blood pressure leading to dizziness when sitting up or standing. Weight gain and sexual difficulties also common when using zotepine.
Rarely, this drug can cause a side effect known as tardive dyskinesia, which involves involuntary movements of body parts such as the face and tongue. Decreased blood cells, another possible effect of zotepine use, can lead to symptoms such as unusual bruising, fatigue, or fever. In some rare cases, use of this medication can lead to a condition called neuroleptic malignant syndrome, which is indicated by symptoms such as muscle stiffness, increased breathing rate, or a severe fever.
Zotepine is typically not used in children, breastfeeding women, individuals currently experiencing symptoms of gout, or anyone who has previously had kidney stones. Close medical supervision is advised for people who are prone to epilepsy, elderly individuals with dementia, those who have heart problems, or anyone with extremely high blood pressure. This drug is also contraindicated for people with Parkinson's disease or certain types of glaucoma.
Atypical antipsychotic medications, sometimes called second-generation antipsychotic drugs, are used to treat a variety of mental health conditions ranging from anxiety disorders to symptoms of bipolar disorder. These medicines are not chemically related; instead, their classification indicates that they do not work identically to the traditional antipsychotic medications. Historically, clozapine was the first of the atypical antipsychotics to be put into clinical use in the 1970s, though it did not achieve FDA approval until 1990. Other second-generation antipsychotics currently in use in the U.S. are olanzapine, trade name Zyprexa®; quetiapine, trade name Seroquel®; aririprazole, trade name Abilify®; and risperidone, trade name Risperdal®.