8-OH-Amoxapine
amoxapine metabolite
What it isThe 8-hydroxy metabolite of amoxapine, retaining D2 antagonism and noradrenergic reuptake inhibition.
Why it mattersIt carries much of amoxapine’s antipsychotic activity, which is why a tricyclic causes extrapyramidal effects.
What it changesIt is why amoxapine can cause tardive dyskinesia — a risk not expected from an antidepressant.
FDA-approved for
- depression (metabolite of amoxapine)
NO BOXED WARNINGS
Principal riskLittle in its own right; see the parent drug
Classes and tags
Clinical profile
Serotonicity
This drug is routinely called serotonergic. By Gillman’s human-effect criteria it does not raise serotonin in the synapse.
It binds the serotonin transporter, and its SERT peg is drawn to that textbook affinity. The pale halo around the peg marks binding that, by Gillman’s human-effect criteria, does not produce clinical serotonin reuptake inhibition.
Gillman’s four human testsA measurable SERT affinity that fails all four is not clinical serotonicity.
- Retarded orgasm
- Efficacy in OCD and cataplexy
- Clonus and hyperreflexia in single-drug overdose
- Serotonin toxicity when combined with an MAOI
Evidence confidenceModerate
Background: what serotonicity is · what is and is not an SRI · what counts as a relevant MAOI.