We reported the results of a survey of patients who suffered from
schizophrenia with predominate hallucinatory and delusional states, and who had been unresponsive to a variety of
antipsychotics like
haloperidol but responded more favorably to
zotepine. In 10 of the 22
zotepine-responsive patients in this study, there was marked improvement with
zotepine. Considering the results from previous
drug treatment, the
phenothiazines (especially
levomepromazine) surpassed the
butyrophenones in efficacy, suggesting that
zotepine might resemble
levomepromazine clinically. After administration of
zotepine, cenesthesic
hallucination, behavior caused by
hallucination, egorrhoe, affective symptoms, and catatonic symptoms were markedly improved. However, insight into disease and negative symptoms were minimally improved after administration of
zotepine.
Zotepine was effective in the refractory
psychoses due to its potent action on the delusional dynamics, in spite of producing little marked improvement in such main symptoms as
hallucination and delusion. The authors speculate that
zotepine's potent activity at serotonin-1 receptors may lead to a beneficial effect in refractory
psychoses, just as in the case of its
antimanic effect.