Drugs to Treat Schizophrenia and Psychosis (Dopamine Antagonists and Partial Agonists Other Than Clozapine)

Author(s):  
Robert McCutcheon ◽  
Stephen J. Kaar ◽  
Oliver D. Howes
2020 ◽  
pp. 487-495
Author(s):  
Stefan Leucht ◽  
Andrea Cipriani ◽  
Toshi A. Furukawa

Antipsychotic drugs should be efficacious for all psychotic symptoms, whether they occur in schizophrenia, depression, mania, or any other psychotic disorder. All currently marketed antipsychotic drugs are dopamine antagonists or partial agonists, making the role of dopamine blockade in this context the most likely mechanism of action. Antipsychotics show efficacy in treatment and in maintenance across the common psychosis diagnoses, especially when looking across large metanalyses. Yet, there is an important imbalance as to how well the pharmacological treatment of the different psychotic disorders have been addressed in the literature, with schizophrenia being predominant.


Author(s):  
Domenico De Berardis ◽  
Tiziano Acciavatti ◽  
Daniela Campanella ◽  
Nicola Serroni ◽  
Luigi Olivieri ◽  
...  

2021 ◽  
pp. 106002802098701
Author(s):  
Stacy L. Haber ◽  
April Graybill ◽  
Ani Minasian

Objective: To review the pharmacology, efficacy, and safety of amisulpride and determine its role in the management of postoperative nausea and vomiting (PONV). Data Sources: A PubMed search (1946 to November 2020) using the terms amisulpride and APD421 was conducted. Study Selection and Data Extraction: Relevant reports on intravenous amisulpride were included. Data Synthesis: Six clinical trials were evaluated. In 4 trials on the prevention of PONV, a greater percentage of patients who received amisulpride 5 mg compared with placebo experienced a complete response (44%-60% vs 31%-33%, respectively, when used as monotherapy; 58% vs 47%, respectively, when used in combination with another antiemetic). In 2 trials on the treatment of PONV, a significantly greater percentage of patients who received amisulpride 10 mg compared with placebo experienced a complete response (31.4% vs 21.5%, respectively, in patients who had not received prophylaxis; 41.7% vs 28.5%, respectively, in patients who had received prophylaxis). Adverse effects included infusion site pain, chills, hypokalemia, procedural hypotension, and abdominal distension. Relevance to Patient Care and Clinical Practice: Amisulpride is effective for the management of PONV and may be less likely to cause QT prolongation and extrapyramidal symptoms than other dopamine antagonists. Additional information is needed on its use for chemotherapy-induced nausea and vomiting and in children. Conclusions: Amisulpride is an important new option for the multimodal management of PONV in adults, and it may be the preferred dopamine antagonist because of the more favorable safety profile that results from its unique pharmacological properties.


Biomolecules ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 104
Author(s):  
Béla Kiss ◽  
István Laszlovszky ◽  
Balázs Krámos ◽  
András Visegrády ◽  
Amrita Bobok ◽  
...  

Dopamine (DA), as one of the major neurotransmitters in the central nervous system (CNS) and periphery, exerts its actions through five types of receptors which belong to two major subfamilies such as D1-like (i.e., D1 and D5 receptors) and D2-like (i.e., D2, D3 and D4) receptors. Dopamine D3 receptor (D3R) was cloned 30 years ago, and its distribution in the CNS and in the periphery, molecular structure, cellular signaling mechanisms have been largely explored. Involvement of D3Rs has been recognized in several CNS functions such as movement control, cognition, learning, reward, emotional regulation and social behavior. D3Rs have become a promising target of drug research and great efforts have been made to obtain high affinity ligands (selective agonists, partial agonists and antagonists) in order to elucidate D3R functions. There has been a strong drive behind the efforts to find drug-like compounds with high affinity and selectivity and various functionality for D3Rs in the hope that they would have potential treatment options in CNS diseases such as schizophrenia, drug abuse, Parkinson’s disease, depression, and restless leg syndrome. In this review, we provide an overview and update of the major aspects of research related to D3Rs: distribution in the CNS and periphery, signaling and molecular properties, the status of ligands available for D3R research (agonists, antagonists and partial agonists), behavioral functions of D3Rs, the role in neural networks, and we provide a summary on how the D3R-related drug research has been translated to human therapy.


1994 ◽  
Vol 25 (4) ◽  
pp. 419-425 ◽  
Author(s):  
A. I. GLABOKOV ◽  
J. KOURIL ◽  
E. V. MIKODINA ◽  
T. BARTH

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110236
Author(s):  
Kimberley Yu ◽  
Madeline Chadehumbe

While cluster headaches are classified and considered a primary headache disorder, secondary causes of cluster headaches have been reported and may provide insight into cluster headaches’ potential pathophysiology. The mechanisms underlying this headache phenotype are poorly understood, and several theories have been proposed that range from the activation within the posterior hypothalamus to autonomic tone dysfunction. We provide a review of reported cases in the literature describing secondary causes after cardiac procedures. We will present a novel pediatric case report of a 16-year-old boy with an isolated innominate artery who presented with acute new-onset headaches 8 h following cardiac catheterization of the aortic arch with arteriography and left pulmonary artery stent placement. The headaches were characterized by attacks of excruciating pain behind the left eye and jaw associated with ipsilateral photophobia, conjunctival injection, rhinorrhea, with severe agitation and restlessness. These met the International Classification of Headache Disorders-3 criteria for episodic cluster headaches. The headaches failed to respond to non-steroidal anti-inflammatory medications, dopamine antagonists, and steroids. He showed an immediate response to treatment with oxygen. This unique case of cluster headaches following cardiac catheterization in a pediatric patient with an isolated innominate artery may provide new insight into cluster headaches’ pathogenesis. We hypothesize that the cardiac catheterization induced cardiac autonomic changes that contributed to the development of his cluster headaches. The role of aortic arch anomalies and procedures in potential disruption of the autonomic tone and the causation of cluster headaches is an area requiring further study.


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