Low-dose zotepine in the maintenance treatment of schizophrenia

Zotepine is new tricyclic neuroleptic with a pharmacological profile comparable to substances such as thioridazine and chlorpromazine. Its chemical structure is related to clozapine and fluperlapine. Ten patients (8 men and 2 women) fulfilling DSM III criteria for residual schizophrenia participated in an open clinical trial that lasted 8 months. The effects of low-dose maintenance therapy with Zotepine were evaluated using the Brief Psychiatric Rating Scale and the Scale for the Assessment of Negative Symptoms. Eight patients dropped out of the study within the first 6 months, 5 because of acute psychotic relapse, 3 due to compliance problems. Psychotic relapse appeared to be indicated by increasing BPRS and SANS scores recorded 1 month before relapse. Apart from minor sedation, no side effects, especially none of the extrapyramidal motor type, were observed. Even though Zotepine does not seem to possess sufficient prophylactic properties against psychotic relapse, preliminary results suggest that it might play an important role as a supplement to conventional neuroleptics in the near future.