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Introduction:
2. Neurochemical Mechanisms:
2.1. Dopaminergic System:
- The primary target of antipsychotic drugs is the dopaminergic system, which
plays a central role in regulating mood, motivation, and psychosis.
- Overactivity of dopamine in certain brain regions is associated with symptoms of
psychosis, including hallucinations and delusions.
- Antipsychotics work by blocking dopamine receptors, particularly D2 receptors,
to reduce dopaminergic activity.
1. Dopaminergic System:
- The dopaminergic system is a key player in the pathophysiology of psychotic
disorders, particularly schizophrenia.
- Dopamine is a neurotransmitter that plays diverse roles in the brain, including
regulating mood, motivation, and reward.
- Dysregulation of dopamine transmission is associated with the positive symptoms of
psychosis, such as hallucinations and delusions.
2. Serotonergic System:
- In addition to their action on dopamine receptors, some atypical antipsychotic drugs
also interact with the serotonin (5-HT) system.
- Serotonin is another important neurotransmitter implicated in mood regulation and
cognitive function.
3. Pharmacological Classification:
Antipsychotic drugs can be classified into two main categories:
4.1.1. Haloperidol:
- A potent D2 receptor antagonist.
- Used in the treatment of acute psychosis and agitation.
- Known for its high risk of EPS.
4.1.2. Chlorpromazine:
- One of the first antipsychotic drugs.
- Also used to manage nausea and vomiting.
- Less potent D2 receptor antagonist than haloperidol.
4.2.3. Quetiapine:
- Used in the management of bipolar disorder and schizophrenia.
- May be sedating and cause orthostatic hypotension.
4.3.1. Aripiprazole:
- A partial D2 receptor agonist.
- May be less likely to cause EPS.
- Used for schizophrenia and bipolar disorder.
4.3.2. Brexpiprazole:
- A newer antipsychotic with a mixed receptor profile.
- Indicated for schizophrenia and major depressive disorder.
5. Therapeutic Uses:
5.1. Schizophrenia:
- Antipsychotic drugs are the cornerstone of schizophrenia treatment.
- They help alleviate positive symptoms (hallucinations, delusions) and sometimes
improve negative symptoms (social withdrawal, apathy).
- Second-generation antipsychotics are often preferred due to their reduced risk of
EPS.
6.3. Hyperprolactinemia:
- Some antipsychotics, like risperidone, can elevate prolactin levels, leading to
sexual dysfunction and breast development in men (gynecomastia).
7. Individualization of Treatment:
- The choice of antipsychotic drug should be based on an individual's specific
diagnosis, symptomatology, and tolerability.
- Monitoring for side effects and therapeutic response is essential.
- Shared decision-making between the patient and healthcare provider is crucial in
treatment planning.
8. Conclusion: