クロザピン
概要
説明
クロザピンは、他の抗精神病薬治療に十分な効果が得られなかった患者さんの統合失調症および統合失調感情障害の治療に主に使用される非定型抗精神病薬です . クロザピンは第2世代の抗精神病薬の先駆けであり、統合失調症患者における自殺行動の抑制効果で知られています . クロザピンは、パーキンソン病の精神病の治療にも使用されます .
2. 製法
合成経路と反応条件： クロザピンは、8-クロロ-11-(4-メチルピペラジン-1-イル)-5H-ジベンゾ[b,e][1,4]ジアゼピンと様々な試薬を反応させる多段階プロセスによって合成されます .
工業生産方法： クロザピンの工業生産は、収率と純度を高めるために最適化された反応条件を用いて、大規模合成を行います。 プロセスには、粉末の調合、接着剤の調合、造粒、全混合、錠剤化などのステップが含まれます . 流動床などの高度な機器を使用して、造粒および乾燥プロセスの効率を向上させています .
作用機序
クロザピンは、ドパミン2型（D2）受容体とセロトニン2A型（5-HT2A）受容体の拮抗作用によって効果を発揮します . また、ムスカリン、アドレナリン、ヒスタミンなどの他の神経受容体とも相互作用します . この複数の受容体結合プロファイルは、クロザピンの独特の有効性と副作用プロファイルに貢献しています .
類似の化合物：
クエチアピン： 受容体結合プロファイルが類似していますが、副作用と有効性が異なる非定型抗精神病薬です.
クロザピンの独自性： クロザピンは、治療抵抗性統合失調症に対する優れた有効性と自殺行動を抑制する能力を持つため、独特です . また、第1世代の抗精神病薬に比べて、錐体外路症状のリスクが低いです .
科学的研究の応用
Pharmacological Profile and Mechanism of Action
Clozapine operates through multiple neurotransmitter systems, impacting serotonin, dopamine, and norepinephrine receptors. This broad action contributes to its efficacy in treating psychotic symptoms and reducing suicidal behavior in patients with schizophrenia.
Key Mechanisms:
- Dopamine Receptor Antagonism: Clozapine primarily antagonizes D2 dopamine receptors, which helps alleviate psychotic symptoms.
- Serotonin Receptor Modulation: It also affects 5-HT2A receptors, which may contribute to its lower risk of extrapyramidal side effects compared to first-generation antipsychotics.
- Anti-Suicidal Properties: Research indicates that clozapine significantly reduces the risk of suicide in patients with schizophrenia and schizoaffective disorder .
Clinical Applications
Clozapine is indicated for:
- Treatment-Resistant Schizophrenia: It is specifically approved for patients who have not responded adequately to at least two other antipsychotic medications. Studies show that clozapine can lead to a 10% reduction in overall mortality among these patients .
- Suicidal Behavior Reduction: Clozapine is effective in decreasing the risk of recurrent suicidal behavior, making it a crucial option for high-risk patients .
- Cognitive Improvement: Some studies suggest that clozapine may enhance cognitive functioning, particularly in working memory, due to its metabolite N-desmethylclozapine .
Efficacy and Safety
A systematic review highlighted the superior efficacy of clozapine compared to both first-generation and second-generation antipsychotics. The meta-analysis included data from 112 studies, confirming clozapine's effectiveness across various psychotic disorders .
Adverse Effects:
Despite its benefits, clozapine is associated with significant risks:
- Severe Neutropenia: Regular monitoring of white blood cell counts is required due to the risk of agranulocytosis.
- Seizures: The risk increases with higher doses.
- Metabolic Syndrome: Weight gain and metabolic changes are common side effects .
Case Study 1: Treatment-Resistant Schizophrenia
A 30-year-old female patient diagnosed with treatment-resistant schizophrenia was treated with clozapine after failing multiple antipsychotic regimens. Following initiation at a low dose (12.5 mg), her symptoms improved significantly over several weeks, demonstrating clozapine's effectiveness in managing severe psychotic symptoms .
Case Study 2: Acute Psychotic Relapse
In another case, a 57-year-old female patient experienced an acute relapse while on clozapine. Adjustments to her medication regimen led to stabilization after a dose reduction from 700 mg/day to a more manageable level. This case illustrates the need for careful monitoring and dose adjustments during treatment .
Data Summary
準備方法
Synthetic Routes and Reaction Conditions: Clozapine is synthesized through a multi-step process involving the reaction of 8-chloro-11-(4-methylpiperazin-1-yl)-5H-dibenzo[b,e][1,4]diazepine with various reagents .
Industrial Production Methods: Industrial production of clozapine involves large-scale synthesis using optimized reaction conditions to ensure high yield and purity. The process includes steps such as premixed powder preparation, adhesive preparation, granulation, total mixing, and tabletting . Advanced equipment like fluidized beds are used to improve the efficiency of granulation and drying processes .
化学反応の分析
反応の種類： クロザピンは、酸化、還元、置換など、様々な化学反応を起こします .
一般的な試薬と条件：
酸化： 通常、過酸化水素や過マンガン酸カリウムなどの試薬を制御された条件下で使用します。
還元： 一般的に、水素化リチウムアルミニウムや水素化ホウ素ナトリウムなどの試薬を使用します。
生成される主要な生成物： これらの反応から生成される主要な生成物には、様々なクロザピン誘導体が含まれ、それらは異なる薬理学的特性を持つ可能性があります .
4. 科学研究への応用
クロザピンは、科学研究において幅広い用途があります。
類似化合物との比較
Quetiapine: Another atypical antipsychotic with a similar receptor binding profile but different side effects and efficacy.
Aripiprazole: Known for its partial agonist activity at dopamine receptors, offering a different mechanism of action compared to clozapine.
Olanzapine: Shares some pharmacological properties with clozapine but has a higher risk of metabolic side effects.
Uniqueness of Clozapine: Clozapine is unique due to its superior efficacy in treatment-resistant schizophrenia and its ability to reduce suicidal behavior . It also has a lower risk of extrapyramidal side effects compared to first-generation antipsychotics .
生物活性
Clozapine is an atypical antipsychotic medication primarily used for treatment-resistant schizophrenia (TRS). Its unique pharmacological profile and biological activity distinguish it from other antipsychotics, making it a subject of extensive research. This article delves into the biological activity of clozapine, its mechanisms of action, clinical findings, and relevant case studies.
Clozapine exhibits a complex pharmacological profile, interacting with multiple neurotransmitter systems. Notably, it has a low affinity for dopamine D2 receptors compared to first-generation antipsychotics. Instead, clozapine acts as an antagonist at various receptors:
| Receptor Type | Binding Affinity (Ki) |
|---|---|
| Histamine H1 | 1.1 nM |
| Adrenergic α1A | 1.6 nM |
| Serotonin 5-HT6 | 4 nM |
| Serotonin 5-HT2A | 5.4 nM |
| Muscarinic M1 | 6.2 nM |
| Dopamine D4 | 24 nM |
| Dopamine D2 | 160 nM |
This diverse receptor binding profile suggests that clozapine's efficacy in treating TRS may stem from its ability to modulate neurotransmission across multiple pathways, including serotonergic and glutamatergic systems .
Clinical Efficacy and Patient Experiences
Clozapine is particularly effective in patients who do not respond to other antipsychotic treatments. A systematic review involving 1,487 patients indicated that most reported positive experiences with clozapine, highlighting significant symptom improvement and overall satisfaction despite some common side effects such as hypersalivation and weight gain .
Case Study: Cognitive Effects
A notable case study examined the cognitive effects of clozapine on a patient with TRS. The findings suggested that cognitive impairment could be dose-dependent, emphasizing the need for careful monitoring of dosage to optimize therapeutic outcomes while minimizing adverse effects .
Neurobiological Effects
Research indicates that clozapine influences neurobiological functioning in patients with TRS. For instance, a study by Molina et al. demonstrated that clozapine treatment was associated with reductions in prefrontal cortical metabolic activity, which correlated with improvements in both positive and negative symptoms of schizophrenia . This suggests that alterations in brain metabolism may play a crucial role in the drug's therapeutic effects.
Metabolite Activity
Clozapine is metabolized into several active metabolites, including N-desmethylclozapine. Studies have shown that this metabolite retains biological activity and can influence Fos protein expression in specific brain regions, mirroring the effects of clozapine itself . This finding underscores the importance of considering both the parent compound and its metabolites when evaluating clozapine's overall pharmacological impact.
Safety Profile
Concerns regarding the safety of clozapine have been addressed in recent studies. A large cohort study conducted by researchers at the University of Hong Kong found that the risk of developing blood cancer associated with clozapine use is very low—less than six cases per 10,000 patients treated annually . These findings support the continued use of clozapine in clinical practice while emphasizing the importance of regular blood monitoring to mitigate risks.
特性
IUPAC Name |
3-chloro-6-(4-methylpiperazin-1-yl)-11H-benzo[b][1,4]benzodiazepine |
Source
|
|---|---|---|
| Source | PubChem | |
| URL | https://pubchem.ncbi.nlm.nih.gov | |
| Description | Data deposited in or computed by PubChem | |
InChI |
InChI=1S/C18H19ClN4/c1-22-8-10-23(11-9-22)18-14-4-2-3-5-15(14)20-16-7-6-13(19)12-17(16)21-18/h2-7,12,20H,8-11H2,1H3 |
Source
|
| Source | PubChem | |
| URL | https://pubchem.ncbi.nlm.nih.gov | |
| Description | Data deposited in or computed by PubChem | |
InChI Key |
QZUDBNBUXVUHMW-UHFFFAOYSA-N |
Source
|
| Source | PubChem | |
| URL | https://pubchem.ncbi.nlm.nih.gov | |
| Description | Data deposited in or computed by PubChem | |
Canonical SMILES |
CN1CCN(CC1)C2=NC3=C(C=CC(=C3)Cl)NC4=CC=CC=C42 |
Source
|
| Source | PubChem | |
| URL | https://pubchem.ncbi.nlm.nih.gov | |
| Description | Data deposited in or computed by PubChem | |
Molecular Formula |
C18H19ClN4 |
Source
|
| Source | PubChem | |
| URL | https://pubchem.ncbi.nlm.nih.gov | |
| Description | Data deposited in or computed by PubChem | |
DSSTOX Substance ID |
DTXSID5022855, DTXSID401020663 |
Source
|
| Record name | Clozapine | |
| Source | EPA DSSTox | |
| URL | https://comptox.epa.gov/dashboard/DTXSID5022855 | |
| Description | DSSTox provides a high quality public chemistry resource for supporting improved predictive toxicology. | |
| Record name | 8-Chloro-11-(4-methyl-1-piperazinyl)-10H-dibenzo[b,e][1,4]diazepine | |
| Source | EPA DSSTox | |
| URL | https://comptox.epa.gov/dashboard/DTXSID401020663 | |
| Description | DSSTox provides a high quality public chemistry resource for supporting improved predictive toxicology. | |
Molecular Weight |
326.8 g/mol |
Source
|
| Source | PubChem | |
| URL | https://pubchem.ncbi.nlm.nih.gov | |
| Description | Data deposited in or computed by PubChem | |
Physical Description |
Solid |
Source
|
| Record name | Clozapine | |
| Source | Human Metabolome Database (HMDB) | |
| URL | http://www.hmdb.ca/metabolites/HMDB0014507 | |
| Description | The Human Metabolome Database (HMDB) is a freely available electronic database containing detailed information about small molecule metabolites found in the human body. | |
| Explanation | HMDB is offered to the public as a freely available resource. Use and re-distribution of the data, in whole or in part, for commercial purposes requires explicit permission of the authors and explicit acknowledgment of the source material (HMDB) and the original publication (see the HMDB citing page). We ask that users who download significant portions of the database cite the HMDB paper in any resulting publications. | |
Solubility |
Solubility wt/wt at 25 °C: water <0.01, Solubility wt/wt at 25 °C: Acetone >5; acetonitrile 1.9; chloroform >20; ethhyl acetate >5; absolute ethanol 4.0, 1.86e-01 g/L |
Source
|
| Record name | Clozapine | |
| Source | DrugBank | |
| URL | https://www.drugbank.ca/drugs/DB00363 | |
| Description | The DrugBank database is a unique bioinformatics and cheminformatics resource that combines detailed drug (i.e. chemical, pharmacological and pharmaceutical) data with comprehensive drug target (i.e. sequence, structure, and pathway) information. | |
| Explanation | Creative Common's Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/legalcode) | |
| Record name | CLOZAPINE | |
| Source | Hazardous Substances Data Bank (HSDB) | |
| URL | https://pubchem.ncbi.nlm.nih.gov/source/hsdb/6478 | |
| Description | The Hazardous Substances Data Bank (HSDB) is a toxicology database that focuses on the toxicology of potentially hazardous chemicals. It provides information on human exposure, industrial hygiene, emergency handling procedures, environmental fate, regulatory requirements, nanomaterials, and related areas. The information in HSDB has been assessed by a Scientific Review Panel. | |
| Record name | Clozapine | |
| Source | Human Metabolome Database (HMDB) | |
| URL | http://www.hmdb.ca/metabolites/HMDB0014507 | |
| Description | The Human Metabolome Database (HMDB) is a freely available electronic database containing detailed information about small molecule metabolites found in the human body. | |
| Explanation | HMDB is offered to the public as a freely available resource. Use and re-distribution of the data, in whole or in part, for commercial purposes requires explicit permission of the authors and explicit acknowledgment of the source material (HMDB) and the original publication (see the HMDB citing page). We ask that users who download significant portions of the database cite the HMDB paper in any resulting publications. | |
Mechanism of Action |
Clozapine's antipsychotic action is likely mediated through a combination of antogistic effects at D2 receptors in the mesolimbic pathway and 5-HT2A receptors in the frontal cortex. D2 antagonism relieves positive symptoms while 5-HT2A antagonism alleviates negative symptoms., Clozapine is classified as an 'atypical' antipsychotic drug because its profile of binding to dopamine receptors and its effects on various dopamine mediated behaviors differ from those exhibited by more typical antipsychotic drug products. In particular, although clozapine does interfere with the binding of dopamine at D1, D2, D3 and D5 receptors, and has a high affinity for the D4 receptor, it does not induce catalepsy nor inhibit apomorphine-induced stereotypy. This evidence, consistent with the view that clozapine is preferentially more active at limbic than at striatal dopamine receptors, may explain the relative freedom of clozapine from extrapyramidal side effects. Clozapine also acts as an antagonist at adrenergic, cholinergic, histaminergic and serotonergic receptors. |
Source
|
| Record name | Clozapine | |
| Source | DrugBank | |
| URL | https://www.drugbank.ca/drugs/DB00363 | |
| Description | The DrugBank database is a unique bioinformatics and cheminformatics resource that combines detailed drug (i.e. chemical, pharmacological and pharmaceutical) data with comprehensive drug target (i.e. sequence, structure, and pathway) information. | |
| Explanation | Creative Common's Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/legalcode) | |
| Record name | CLOZAPINE | |
| Source | Hazardous Substances Data Bank (HSDB) | |
| URL | https://pubchem.ncbi.nlm.nih.gov/source/hsdb/6478 | |
| Description | The Hazardous Substances Data Bank (HSDB) is a toxicology database that focuses on the toxicology of potentially hazardous chemicals. It provides information on human exposure, industrial hygiene, emergency handling procedures, environmental fate, regulatory requirements, nanomaterials, and related areas. The information in HSDB has been assessed by a Scientific Review Panel. | |
Color/Form |
Yellow crystals from acetone-petroleum ether | |
CAS No. |
5786-21-0, 1333667-72-3 |
Source
|
| Record name | Clozapine | |
| Source | CAS Common Chemistry | |
| URL | https://commonchemistry.cas.org/detail?cas_rn=5786-21-0 | |
| Description | CAS Common Chemistry is an open community resource for accessing chemical information. Nearly 500,000 chemical substances from CAS REGISTRY cover areas of community interest, including common and frequently regulated chemicals, and those relevant to high school and undergraduate chemistry classes. This chemical information, curated by our expert scientists, is provided in alignment with our mission as a division of the American Chemical Society. | |
| Explanation | The data from CAS Common Chemistry is provided under a CC-BY-NC 4.0 license, unless otherwise stated. | |
| Record name | Clozapine [USAN:USP:INN:BAN] | |
| Source | ChemIDplus | |
| URL | https://pubchem.ncbi.nlm.nih.gov/substance/?source=chemidplus&sourceid=0005786210 | |
| Description | ChemIDplus is a free, web search system that provides access to the structure and nomenclature authority files used for the identification of chemical substances cited in National Library of Medicine (NLM) databases, including the TOXNET system. | |
| Record name | Clozapine | |
| Source | DrugBank | |
| URL | https://www.drugbank.ca/drugs/DB00363 | |
| Description | The DrugBank database is a unique bioinformatics and cheminformatics resource that combines detailed drug (i.e. chemical, pharmacological and pharmaceutical) data with comprehensive drug target (i.e. sequence, structure, and pathway) information. | |
| Explanation | Creative Common's Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/legalcode) | |
| Record name | clozapine | |
| Source | DTP/NCI | |
| URL | https://dtp.cancer.gov/dtpstandard/servlet/dwindex?searchtype=NSC&outputformat=html&searchlist=757429 | |
| Description | The NCI Development Therapeutics Program (DTP) provides services and resources to the academic and private-sector research communities worldwide to facilitate the discovery and development of new cancer therapeutic agents. | |
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| Record name | Clozapine | |
| Source | EPA DSSTox | |
| URL | https://comptox.epa.gov/dashboard/DTXSID5022855 | |
| Description | DSSTox provides a high quality public chemistry resource for supporting improved predictive toxicology. | |
| Record name | 8-Chloro-11-(4-methyl-1-piperazinyl)-10H-dibenzo[b,e][1,4]diazepine | |
| Source | EPA DSSTox | |
| URL | https://comptox.epa.gov/dashboard/DTXSID401020663 | |
| Description | DSSTox provides a high quality public chemistry resource for supporting improved predictive toxicology. | |
| Record name | Clozapine | |
| Source | European Chemicals Agency (ECHA) | |
| URL | https://echa.europa.eu/substance-information/-/substanceinfo/100.024.831 | |
| Description | The European Chemicals Agency (ECHA) is an agency of the European Union which is the driving force among regulatory authorities in implementing the EU's groundbreaking chemicals legislation for the benefit of human health and the environment as well as for innovation and competitiveness. | |
| Explanation | Use of the information, documents and data from the ECHA website is subject to the terms and conditions of this Legal Notice, and subject to other binding limitations provided for under applicable law, the information, documents and data made available on the ECHA website may be reproduced, distributed and/or used, totally or in part, for non-commercial purposes provided that ECHA is acknowledged as the source: "Source: European Chemicals Agency, http://echa.europa.eu/". Such acknowledgement must be included in each copy of the material. ECHA permits and encourages organisations and individuals to create links to the ECHA website under the following cumulative conditions: Links can only be made to webpages that provide a link to the Legal Notice page. | |
| Record name | CLOZAPINE | |
| Source | FDA Global Substance Registration System (GSRS) | |
| URL | https://gsrs.ncats.nih.gov/ginas/app/beta/substances/J60AR2IKIC | |
| Description | The FDA Global Substance Registration System (GSRS) enables the efficient and accurate exchange of information on what substances are in regulated products. Instead of relying on names, which vary across regulatory domains, countries, and regions, the GSRS knowledge base makes it possible for substances to be defined by standardized, scientific descriptions. | |
| Explanation | Unless otherwise noted, the contents of the FDA website (www.fda.gov), both text and graphics, are not copyrighted. They are in the public domain and may be republished, reprinted and otherwise used freely by anyone without the need to obtain permission from FDA. Credit to the U.S. Food and Drug Administration as the source is appreciated but not required. | |
| Record name | CLOZAPINE | |
| Source | Hazardous Substances Data Bank (HSDB) | |
| URL | https://pubchem.ncbi.nlm.nih.gov/source/hsdb/6478 | |
| Description | The Hazardous Substances Data Bank (HSDB) is a toxicology database that focuses on the toxicology of potentially hazardous chemicals. It provides information on human exposure, industrial hygiene, emergency handling procedures, environmental fate, regulatory requirements, nanomaterials, and related areas. The information in HSDB has been assessed by a Scientific Review Panel. | |
| Record name | Clozapine | |
| Source | Human Metabolome Database (HMDB) | |
| URL | http://www.hmdb.ca/metabolites/HMDB0014507 | |
| Description | The Human Metabolome Database (HMDB) is a freely available electronic database containing detailed information about small molecule metabolites found in the human body. | |
| Explanation | HMDB is offered to the public as a freely available resource. Use and re-distribution of the data, in whole or in part, for commercial purposes requires explicit permission of the authors and explicit acknowledgment of the source material (HMDB) and the original publication (see the HMDB citing page). We ask that users who download significant portions of the database cite the HMDB paper in any resulting publications. | |
Melting Point |
183-184 °C, 183 - 184 °C |
Source
|
| Record name | Clozapine | |
| Source | DrugBank | |
| URL | https://www.drugbank.ca/drugs/DB00363 | |
| Description | The DrugBank database is a unique bioinformatics and cheminformatics resource that combines detailed drug (i.e. chemical, pharmacological and pharmaceutical) data with comprehensive drug target (i.e. sequence, structure, and pathway) information. | |
| Explanation | Creative Common's Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/legalcode) | |
| Record name | CLOZAPINE | |
| Source | Hazardous Substances Data Bank (HSDB) | |
| URL | https://pubchem.ncbi.nlm.nih.gov/source/hsdb/6478 | |
| Description | The Hazardous Substances Data Bank (HSDB) is a toxicology database that focuses on the toxicology of potentially hazardous chemicals. It provides information on human exposure, industrial hygiene, emergency handling procedures, environmental fate, regulatory requirements, nanomaterials, and related areas. The information in HSDB has been assessed by a Scientific Review Panel. | |
| Record name | Clozapine | |
| Source | Human Metabolome Database (HMDB) | |
| URL | http://www.hmdb.ca/metabolites/HMDB0014507 | |
| Description | The Human Metabolome Database (HMDB) is a freely available electronic database containing detailed information about small molecule metabolites found in the human body. | |
| Explanation | HMDB is offered to the public as a freely available resource. Use and re-distribution of the data, in whole or in part, for commercial purposes requires explicit permission of the authors and explicit acknowledgment of the source material (HMDB) and the original publication (see the HMDB citing page). We ask that users who download significant portions of the database cite the HMDB paper in any resulting publications. | |
Retrosynthesis Analysis
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Strategy Settings
| Precursor scoring | Relevance Heuristic |
|---|---|
| Min. plausibility | 0.01 |
| Model | Template_relevance |
| Template Set | Pistachio/Bkms_metabolic/Pistachio_ringbreaker/Reaxys/Reaxys_biocatalysis |
| Top-N result to add to graph | 6 |
Feasible Synthetic Routes
試験管内研究製品の免責事項と情報
BenchChemで提示されるすべての記事および製品情報は、情報提供を目的としています。BenchChemで購入可能な製品は、生体外研究のために特別に設計されています。生体外研究は、ラテン語の "in glass" に由来し、生物体の外で行われる実験を指します。これらの製品は医薬品または薬として分類されておらず、FDAから任何の医療状態、病気、または疾患の予防、治療、または治癒のために承認されていません。これらの製品を人間または動物に体内に導入する形態は、法律により厳格に禁止されています。これらのガイドラインに従うことは、研究と実験において法的および倫理的な基準の遵守を確実にするために重要です。
