Pharmacology of antipsychotics

Introduction to this topic

Dr Peter Talbot
Senior Lecturer in Psychiatry & Honorary Consultant Psychiatrist, University of Manchester

Updated: Friday, 21st June 2013
Last Checked: Thursday, 31st August 2017 Current

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Following a description of the brain dopamine systems, and a summary of dopamine abnormalities in schizophrenia, this topic describes how region-specific D2 receptor antagonism results in antipsychotic efficacy, hyperprolactinaemia and adverse motor ("extrapyramidal") effects as increasing D2 receptor occupancy thresholds are passed with increasing drug doses. It goes on to describe how the relative ability of some drugs to avoid these side effects at clinically effective doses (their "atypicality") is driven mainly by low D2 affinity, as well as other mechanisms such as intrinsic partial D2 agonism and intrinsic anticholinergic effects. It concludes that serotonin 5-HT2A receptor antagonism is no longer thought to play a prominent role in conferring an atypical profile, that a clear division of antipsychotics into "typicals" and "atypicals" is not supported by the evidence, and that for most so-called "atypicals" their atypicality is relative and dose-related.

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Sections in this Topic

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Dopamine system

Duration: 10m 23s
No. of slides: 10 - View Slide List

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Mechanism of antipsychotic efficacy

Duration: 13m 36s
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Mechanisms of atypicality I

Duration: 10m 57s
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Mechanisms of atypicality II

Duration: 13m 54s
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