Limits...
Antipsychotic treatments; focus on lurasidone.

Sumiyoshi T - Front Pharmacol (2013)

Bottom Line: However, these views have been partly challenged by results from recent meta-analysis studies.Specifically, cardio-metabolic side effects of AAPDs, in spite of a relative paucity of extrapyramidal symptoms, may sometimes limit the use of these agents.Further investigations are warranted to determine if a larger proportion of patients will be benefitted by treatment with AAPDs compared to TAPDs in terms of remission and recovery.

View Article: PubMed Central - PubMed

Affiliation: Neurocognition and Pharmacology Laboratory, Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences Toyama, Japan.

ABSTRACT
The introduction of atypical antipsychotic drugs (AAPDs), or second-generation antipsychotics, with clozapine as the prototype, has largely changed the clinicians' attitudes toward the treatment of mental illnesses including, but not limited to schizophrenia. Initially, there was optimism that AAPDs would be superior over typical antipsychotic drugs (TAPDs), or first-generation antipsychotic drugs, in terms of efficacy in various phenomenological aspects, including cognitive impairment, and less likelihood of causing adverse events. However, these views have been partly challenged by results from recent meta-analysis studies. Specifically, cardio-metabolic side effects of AAPDs, in spite of a relative paucity of extrapyramidal symptoms, may sometimes limit the use of these agents. Accordingly, attempts have been made to develop newer compounds, e.g., lurasidone, with the aim of increasing efficacy and tolerability. Further investigations are warranted to determine if a larger proportion of patients will be benefitted by treatment with AAPDs compared to TAPDs in terms of remission and recovery.

No MeSH data available.


Related in: MedlinePlus

Receptor binding profiles of antipsychotic drugs. A larger pKi value represents a stronger affinity for the particular receptor. [Data from Newman-Tancredi and Kleven (2011)].
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3753015&req=5

Figure 5: Receptor binding profiles of antipsychotic drugs. A larger pKi value represents a stronger affinity for the particular receptor. [Data from Newman-Tancredi and Kleven (2011)].

Mentions: The above AAPDs, except amisulpiride, a relatively selective D2/D3 ligand, share a property of relatively high 5-HT2A vs. D2 receptor affinity (Meltzer et al., 1989; Stockmeier et al., 1993; Sumiyoshi et al., 1995). Some of them, e.g., clozapine, olanzapine and quetiapine, also exhibit considerable affinities for D1, histamine H1, adrenalin-α1, and muscarinic-M1, receptors, and etc. (Meltzer et al., 2003; Newman-Tancredi and Kleven, 2011). Pharmacologic profiles for representative AAPDs can be summarized as eliciting relatively strong affinities for 5-HT1A, 5-HT2C and NA-α1 receptors, in addition to 5-HT2A and D2 receptors, as indicated in Figure 5 (Newman-Tancredi and Kleven, 2011).


Antipsychotic treatments; focus on lurasidone.

Sumiyoshi T - Front Pharmacol (2013)

Receptor binding profiles of antipsychotic drugs. A larger pKi value represents a stronger affinity for the particular receptor. [Data from Newman-Tancredi and Kleven (2011)].
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3753015&req=5

Figure 5: Receptor binding profiles of antipsychotic drugs. A larger pKi value represents a stronger affinity for the particular receptor. [Data from Newman-Tancredi and Kleven (2011)].
Mentions: The above AAPDs, except amisulpiride, a relatively selective D2/D3 ligand, share a property of relatively high 5-HT2A vs. D2 receptor affinity (Meltzer et al., 1989; Stockmeier et al., 1993; Sumiyoshi et al., 1995). Some of them, e.g., clozapine, olanzapine and quetiapine, also exhibit considerable affinities for D1, histamine H1, adrenalin-α1, and muscarinic-M1, receptors, and etc. (Meltzer et al., 2003; Newman-Tancredi and Kleven, 2011). Pharmacologic profiles for representative AAPDs can be summarized as eliciting relatively strong affinities for 5-HT1A, 5-HT2C and NA-α1 receptors, in addition to 5-HT2A and D2 receptors, as indicated in Figure 5 (Newman-Tancredi and Kleven, 2011).

Bottom Line: However, these views have been partly challenged by results from recent meta-analysis studies.Specifically, cardio-metabolic side effects of AAPDs, in spite of a relative paucity of extrapyramidal symptoms, may sometimes limit the use of these agents.Further investigations are warranted to determine if a larger proportion of patients will be benefitted by treatment with AAPDs compared to TAPDs in terms of remission and recovery.

View Article: PubMed Central - PubMed

Affiliation: Neurocognition and Pharmacology Laboratory, Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences Toyama, Japan.

ABSTRACT
The introduction of atypical antipsychotic drugs (AAPDs), or second-generation antipsychotics, with clozapine as the prototype, has largely changed the clinicians' attitudes toward the treatment of mental illnesses including, but not limited to schizophrenia. Initially, there was optimism that AAPDs would be superior over typical antipsychotic drugs (TAPDs), or first-generation antipsychotic drugs, in terms of efficacy in various phenomenological aspects, including cognitive impairment, and less likelihood of causing adverse events. However, these views have been partly challenged by results from recent meta-analysis studies. Specifically, cardio-metabolic side effects of AAPDs, in spite of a relative paucity of extrapyramidal symptoms, may sometimes limit the use of these agents. Accordingly, attempts have been made to develop newer compounds, e.g., lurasidone, with the aim of increasing efficacy and tolerability. Further investigations are warranted to determine if a larger proportion of patients will be benefitted by treatment with AAPDs compared to TAPDs in terms of remission and recovery.

No MeSH data available.


Related in: MedlinePlus