[The mechanisms of action of antipsychotic drugs: is atypicality superior in schizophrenia treatment?].
This review presents the mechanisms of action of typical and atypical antipsychotic drugs, emphasizing the differences in the pharmacology of these drugs used in the treatment of schizophrenia. Initially, the concept of atypicality will be examined through the 2 most widely accepted hypotheses. Hypotheses concerning a high serotonin 5HT2A/dopamine D2 receptor antagonism ratio and a special interaction with D2 receptors via mesolimbic selectivity or a weaker blockade will be discussed. Next, the mechanisms of action of typical and atypical antipsychotics will be explored at the receptor level. Receptor activity of atypical antipsychotics other than D2 receptors at 5HT2A, 5HT2C, 5HT1A, and adrenergic alpha1 and alpha2, along with relevant, currently important, and consistent findings, and other mechanisms of action, such as glutamate modulation and increased prefrontal cortical acetylcholine release will be reviewed. In the final section, some specific mechanisms of action, which might be related to clozapine's superiority in schizophrenia treatment, will be examined. Atypical antipsychotics provide a variety of mechanisms of action as compared to typical antipsychotics, and they might be efficacious in treating symptom domains other than positive symptoms. In clinical practice, the superiority of atypical antipsychotics other than clozapine remains an issue that needs to be proven.
Anil Yağcioğlu
A Elif
AE
Psikiyatri AD., Hacettepe U Tip Fak., Ankara. eanil@hacettepe.edu.tr
D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D012559:Schizophrenia / Q000188:drug therapy*
D014150:Antipsychotic Agents