Mechanisms of antipsychotic drugs

The pharmacological basis of the action of antipsychotic drugs is essential to understanding their effects and limitations in symptom relief, as well as their adverse effects.

This module will focus on the pharmacological mechanisms of the antipsychotic drugs that underlie their actions on the symptoms of schizophrenia. In doing so, it will address some important questions that relate to antipsychotic drug action including:

• How should we subclassify the antipsychotic drugs? What is atypicality and is it a useful concept? Why is action at the dopamine D2 receptor so important?
• How does antipsychotic drug pharmacology relate to the neuropathology of schizophrenia? Why do cognitive symptoms respond so poorly? What might underlie treatment resistance?
• What makes clozapine different? Why are some antipsychotic drugs effective in relieving depressive symptoms? What underlies their efficacy in mania?

Learning objectives

By the end of this module, you should be able to:

• recognise both the importance and limitations of the dopamine hypothesis of schizophrenia, and its relevance to antipsychotic action
• identify the primary pharmacological effects of different classes of antipsychotic drugs and the mechanisms underlying the differences between them
• assess the evidence for the central role of dopamine D2 receptor antagonism in the relief of positive symptoms
• recognise that dopamine hyperfunction is secondary to abnormalities in GABA and/or glutamate neurons, which may in turn relate to cognitive and negative symptoms
• recognise the limitations of D2 antagonism in the response of these symptoms, and some of these symptoms being influenced by the possible role of 5-HT receptor mechanisms.

Availability

This module is available as part of a CPD eLearning subscription.