Schizophrenia neuroleptic pharmacology

Jeste, D. V. etal. (1996). Relationship of ethnicity and gender to schizophrenia and pharmacology of neuroleptics. Psychopharmacol. Bull, 32, 243-51. 

Although the serotonin hypothesis of schizophrenia was formulated at approximately the same time as the discovery of the first neuroleptics, it had no direct connection with the pharmacological propraties of these drugs. The situation is different in the case of the dopamine hypothesis because all known neuroleptics have some inhibitory action on dopaminergic neurons, even though they vary considerably with regard to other pharmacological effects. 

When the pharmacologic properties of two compounds are compared, one may prove to be more potent and efficacious than the other. For instance, as an analgesic, morphine is more potent and more efficacious than acetylsalicylic acid. On the other hand, two compounds may be equally efficacious but one could be more potent. Haloperidol and chlorpromazine are both efficacious neuroleptics in the management of schizophrenia, but haloperidol is more potent. 

In CONCLUSION, the use of the "classical" neuroleptics, as exemplified by the phenothiazines, thioxanthines, butyrophenones and diphenylbutyl-piperidines, has been a landmark in the pharmacotherapy of schizophrenia and psychotic disorders. The efficacy of such drugs in the alleviation of the symptoms of schizophrenia is universally accepted. However, it is also evident that they have a spectrum of adverse effects that frequently renders their long-term use problematic. Side effects such as akathisia, Parkinsonism, tardive dyskinesia and the all too frequent changes in peripheral autonomic activity are largely predictable from the structure of the molecules and the basic animal pharmacology data. Such adverse effects, and the difficulties encountered when attempting to reduce their frequency and severity by concurrent medication, has stimulated the development of "atypical" neuroleptics such as clozapine and risperidone which, hopefully, will combine efficacy with a reduction in side effects. 

Combined use of ChEI with neuroleptic and antidepressant medication Although the successes of most pharmacological treatments for autistic adults are limited, combining medications may prove to be more effective. A study by Wang et al., 2007 examined the synergistic effect of risperidone and galantamine on the phencyclidine-induced mouse model of schizophrenia. Similar to autism, schizophrenic patients suffer from cognitive defects and impaired memory function. 

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