Drug Classes

First-Generation Antipsychotics: An Introduction

Authors: Flavio Guzman, MD; Abimbola Farinde,PharmD First-generation antipsychotics (FGAs) are drugs used primarily for the treatment of schizophrenia and related psychotic disorders. Use of FGAs has declined in the last few years, mainly because of an increase in prescriptions of second-generation agents. Since FGAs are considerably less expensive than newer antipsychotics, they remain a valuable option…

Read More

Mechanism of Action of Quetiapine

By Flavio Guzman, MD. Quetiapine is a second-generation antipsychotic that has affinity for D2, 5-HT2A, H1, alpha 1 and 5-HT1A receptors. Its precise mechanism of action is unknown, but according to the dopamine theory of schizophrenia, antipsychotic effects might be related to the drug’s ability to reduce dopaminergic neurotransmission in the mesolimbic pathway. Quetiapine, D2…

Read More

The Four Dopamine Pathways Relevant to Antipsychotics Pharmacology

By Flavio Guzmán, MD This video describes the 4 dopamine pathways relevant to the mechanism of action and adverse effects of antipsychotic drugs. Presentation outline: General overview of dopaminergic pathways Mesolimbic pathway & positive symptoms of schizophrenia Mesocortical pathway: negative & cognitive symptoms Nigrostriatal pathway & EPS Tuberoinfundibular pathway & prolactin release Summary Transcript Introduction…

Read More

Neurological side effects of antipsychotics: akathisia, dystonia and parkinsonism

This video summarizes acute neurological side effects of antipsychotics: akathisia, dystonia and parkinsonism. 1. Akathisia and Dystonia A classification of neurological side effects Akathisia ( Clinical features, a clinical video, medications that can cause akathisia and management) Acute dystonia (Clinical features, pathophysiology, management) 2. Parkinsonism Clinical features Mechanism of EPS Differences between antipsychotic induced parkinsonism and Parkinson’s…

Read More

Mechanism of Action of Antipsychotic Agents

Author: Flavio Guzman, MD This video discusses the following topics: The dopamine hypothesis of schizophrenia (the evidence that supports it and its limitations). First-generation (typical) antipsychotics are D2 antagonists. Pharmacodynamic profile of second-generation antipsychotics (5-HT2A antagonism, fast D2 dissociation, 5-HT1A agonism). The main differences between first and second generation antipsychotics (from a receptor binding perspective).…

Read More

Antipsychotics for Schizophrenia: A Clinical Overview

By Flavio Guzmán, MD This video lecture is a brief summary of the most recent literature on the evolving field of pharmacological treatment of schizophrenia (see references and further reading). In this video I discuss the following topics: Psychosis and schizophrenia. Why is psychopathology important for understanding benefits and limitations of antipsychotic therapy. The latest…

Read More