Antipsychotics schizophrenic diseases

FIGURE 11—54. Cognitive symptom pharmacy. Atypical antipsychotic dmgs (SDA) may improve cognitive functions in both schizophrenic and Alzheimer patients (first-line treatment). They may boost the actions of cholinesterase inhibitors (ChEIs) in Alzheimer s disease. It may also be useful to discontinue any anticholinergic medication that you can, a welcome bonus when switching from conventional antipsychotics to atypical antipsychotics (decreased A Ch). 

In experimental studies, many clinically effective neuroleptics have been shown to act as 5-HT2A receptor antagonists. Studies on post-mortem brain from schizophrenic patients have shown that the decrease in the number of 5-HT2A receptors in the prefrontal cortex might be related to the disease process. It therefore seems unlikely that the antipsychotic activity of neuroleptics can be explained solely in terms of their action on 5-HT receptors. Furthermore, no correlation exists between the average therapeutic doses of a neuroleptic and its affinity for 5-HT receptors. It does seem possible, however, that several atypical neuroleptics such as amperozide, risperidone and possibly ritanserin do owe at least part of the pharmacological profile to their ability to inhibit 5-HT receptors. 

One obstacle when studying dopamine receptors in schizophrenic subjects, is that most schizophrenics have been treated with antipsychotic agents, all of which block D2 and D3 receptors, and many also block D4 dopamine receptors. Thus, it can be difficult to dissociate effects specific to the disease from the effects of disease treatment. This is an... 

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