Zotepine Appears to Improve the Negative Symptoms And may be of use as combination therapy in patients with residual schizophrenia

Nine patients completed an open study to determine the effects of zotepine on negative symptoms in residual schizophrenia. Zotepine 50-200 mg/day was administered for 8 weeks and psychopathological state was assessed using the Brief Psychiatric Rating Scale (BPRS) and the Scale for Assessment of Negative Symptoms (SANS).

Significant improvement by day 21 was shown by both methods of evaluation . Follow-up observations over 1 year were attempted , with only 2 patients completing this phase . Their resultant BPRS and SANS values decreased. The authors commented that ' ... a daily dosage of 50 to 150mg of zotepine is insufficient in the maintenance therapy of schizophrenia, although a positive effect on negative symptoms seemed to be evident'.

A second study was conducted to observe the effects of zotepine 50mg bid in 11 patients receiving conventional neuroleptic therapy of either fluphenazine decanoate 25mg/3 weeks (n = 6) or oral clozapine 150-300 mg/day (n = 5) during a 1-year period.

A significant improvement was observed by week 6 in the BPRS score (195 vs 27 A with conventional therapy only ; p ~ 0.01) and by week 10 in the SANS score (51 .5 vs 68.7 with conventional therapy only ; p ~ 0.01) . At the end of 1 year, BPRS and SANS evaluations were 16.5 and 436. respectively Side effects were minimal although 2 patients receiving fluphenazine + zotepine experienced mild extrapyramidal motor side effects. Further long term studies of zotepine are ongoing. Barnas C. Stuppaeck C. Unterweger B. Hlnterhuber H Fleischhacker WW Journal of Clinical Psychopharmacology 7 370·371 Oct 1987 [Abstracted from a letter to the edltorl

0156-2703/ 88/ 0123-0011 / 0S01 .00/ 0 © ADIS Press INPHARMA ' 23 January 1988 11