Question

Compare the conventional antipsychotic medications with the newer drugs in terms of their biochemical dynamics, side effects, and treatment effectiveness

Answer 1

The first line of treatment in schizophrenia consists of anti psychotic medications. In earlier times, the antipsychotics were helpful in treating the positive symptoms of schizophrenia such as delusions and hallucinations but failed to address the negative symptoms such as apathy and anhedonia. However, during the 90's, atypical antipsychotics were developed and are now mostly prescribed, these anti psychotics reduce both the positive as well as the negative symptoms. The anti psychotics take about two week to start showing effects in patients.

The typical antipsychotics reduce the positive symptoms of schizophrenia such as delusions and hallucinations but fail to address the the negative symptoms such as social withdrawal and anhedonia. The side effects of typical anti-psychotics include tremors, akathisia,muscle stiffness and parkinsonism. The side effects of atypical anti-psychotics include ardive dyskinesia, neuroleptic malignant syndrome, diabetes and sudden cardiac death.

The third generation anti psychotics work differently from the typical antipsychotic as they reduce the negative symptoms of schizophrenia as well. Atypical anti-psychotics are partial agonist at dopamine receptors, this is important in understanding how antipsychotics work. Atypical antipsychotics work by selectively working at different brain areas in a specific manner, they increase the dopaminergic activity in the prefrontal cortex and reducing it in the mesolimbic system. This means that it works as an antagonist at the mesolimbic system by reducing the dopamine activity and as an agonist at the prefrontal cortex by increasing dopaminergic activity. So, Atypical antipsychotics?, being a the partial agonist, acts as agonist in regions of low concentration of normal ligand and as antagonist in regions where there is high concentration.