SANP Swiss Archives of Neurology, Psychiatry and Psychotherapy 2297-7007 2297-6981 EMH Schweizerischer Ärzteverlag AG Farnsburgerstrasse 8 CH-4132 Muttenz 03243 10.4414/sanp.2022.03243 Review article Schizophrenia, schizotypal and delusional disorders Clothiapine: highlights on pharmacological and clinical profile of an undervalued drug Crapanzano Calogero calogerocrapanzano87@gmail.com Contrada Cannavecchia | Licata | AG | 92100 | ITALY | 3201573104 Amendola Chiara amendolachiara@tiscali.it Azienda USL Toscana Centro, CSM Scandicci, Firenze (Italy) Conigliaro Claudia claudiaconi@msn.com ASPPA, CSM Termini Imerese, Termini Imerese (Italy) Casolaro Ilaria casolaro.ilaria@gmail.com ASST Lariana, Como (Italy) 01 05 2022 173 03 0 0 Copyright: EMH Schweizerischer Ärzteverlag AG 2022 EMH Schweizerischer Ärzteverlag AG "Swiss Archives of Neurology, Psychiatry and Psychotherapy" is an open access publication of EMH published in accordance with the terms of the Creative Commons licence attribution - NonCommercial - NoDerivatives 4.0 International. You are free to share, copy and redistribute the material in any medium or format under the following terms: Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. NonCommercial — You may not use the material for commercial purposes. NoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material. "Non-commercial" means not primarily intended for or directed towards commercial advantage or monetary compensation. The incorporation of publications in commercial products, the use of publications to advertise for commercial products or services and any other usage that directly or indirectly pursues commercial interests is subject to the express previous consent of the publishing house as part of a written agreement. Please send us your request in writing. Exact indication of the publication from which you would like to reproduce material and detailed information about its intended use help to facilitate and expedite request processing.

Clothiapine is a quite widely used, but understudied, first generation antipsychotic with pharmacodynamic properties of aliphatic phenothiazines and clozapine. Aim of our comprehensive review is to summarize state of art of clinical and pharmacological data concerning use of clothiapine on several psychiatric conditions. The main evidence concerns short-term studies evaluating efficacy on schizophrenia versus active comparators. Off-label use in alcohol abstinence and insomnia is also reported with preliminary promising findings. Few studies investigated systematically tolerability and safety of clothiapine, specifically extrapyramidal symptoms and effect on QT, that appear comparable to other first generation antipsychotics. We believe that this drug is not adequately investigated in scientific literature and consequently it risks to be a valid, but underutilized, pharmacological tool in psychiatry.