BACKGROUND Metabolic syndrome is a leading cause of morbidity and mortality in patients with schizophrenia, with a prevalence rate double that of nonpsychiatric populations. Given the amount of evidence suggesting a link between atypical antipsychotic medications and metabolic syndrome, several agencies have recommended regular clinical monitoring of weight, symptoms of hyperglycemia, and gluco...

And there is more, much more. If the FDA enforces these requirements, drug companies would probably not be sending around dubious articles based on bogus clinical trials, which is Waxman’s concern. The bigger risk is that physicians might not pay close enough attention to the risks of off-label use, which can be substantial. These risks come into play in connection with atypical antipsychotic a...

Bipolar disorder is a prevalent disorder that tends to become progressive without treatment and with inadequate treatment. Second generation (atypical) antipsychotic drugs have increasingly been used as adjunctive treatment or monotherapy for mania, but they have the potential for significant adverse effects and their role in maintenance treatment remains unclear. Asenapine is a new atypical an...

Postsynaptic Neuron Figure 1. Conventional vs. Atypical Antipsychotic Mechanisms n last month’s BRAINSTORMS, we discussed a new hypothesis on the mechanism of action of atypical antipsychotics, namely the “hit-and-run” hypothesis. Here we illustrate this concept. Conventional: Because of the biochemical properties of conventional antipsychotics, their binding to postsynaptic dopamine D2 recepto...

Antidepressant medications have eased the suffering of millions of people. In addition to treating depression, antidepressant drugs also treat several anxiety disorders. Unfortunately, there are problematic limitations with antidepressant agents, including a delayed therapeutic response and insufficient efficacy. Emerging evidence shows that atypical antipsychotic agents can be used as augmenta...

The prefrontal cortex (PFC) is involved in higher brain functions altered in schizophrenia. Classical antipsychotic drugs modulate information processing in cortico-limbic circuits via dopamine D2 receptor blockade in nucleus accumbens (NAc) whereas atypical antipsychotic drugs preferentially target cortical serotonin (5-HT) receptors. The brain networks involved in the therapeutic action of at...

BACKGROUND Although the principal brain target that all antipsychotic drugs attach to is the dopamine D2 receptor, traditional or typical antipsychotics, by attaching to it, induce extrapyramidal signs and symptoms (EPS). They also, by binding to the D2 receptor, elevate serum prolactin. Atypical antipsychotics given in dosages within the clinically effective range do not bring about these adve...

To the Editor: Quetiapine is an atypical antipsychotic agent with less propensity than other atypical antipsychotics to induce antipsychotic-associated hyperprolactinemia in standard recommended therapeutic dosages, and when it does induce the condition at all, the rise in serum prolactin level is only transient. Accordingly, quetiapine has been recommended as an alternative in patients who dev...

Recent evidence has suggested that atypical antipsychotic drugs regulate synaptic plasticity. We investigated whether some atypical antipsychotic drugs (olanzapine, aripiprazole, quetiapine, and ziprasidone) altered the expression of synapse-associated proteins in rat hippocampal neuronal cultures under toxic conditions induced by B27 deprivation. A typical antipsychotic, haloperidol, was used ...

BACKGROUND Cardiovascular diseases, cardiovascular risk factors, and mortality due to these situations are more frequently encountered in schizophrenic patients when compared with the general population. The mean platelet volume (MPV) is a surrogate biomarker of the platelet activity and an useful prognostic test in cardiometabolic diseases. The aim of this study was to investigate what influen...