Atypical anti-psychotics: Review article [Los antipsicóticos atípicos: Una revisión]
Por:
García-Anaya M., Apiquian R., Fresán A.
Publicada:
1 ene 2001
Resumen:
This review elucidates a new concept for the classification of atypical antipsychotics based on their mechanism of action. The primary aim in the development of an antipsychotic is that of increasing its efficacy and decreasing the frequency of adverse effects. Atypical antipsychotics have reached this goal by different pharmacological action mechanisms. Recently; a new model was suggested for explaining the action mechanism of atypical antipsychotics. This model suggests that atypical antipsychotics have a constant of faster dissociation from the dopaminergic receptor D2, which modulates antipsychotic response, conditioning a lower frequency of extrapyramidal symptoms and a lower prolactin elevation, which are the essential features of an atypical antipsychotic. To define an antipsychotic as atypical it should prove its efficacy in the positive and the negative symptoms of schizophrenia; it should be outstandingly efficient in patients with partial response or lack of it to typical antipsychotics, and it must have at least two of the following properties: no association with subjective dysphoria, low sedative effect, few cardiac/autonomic side effects, mild elevation of prolactin levels, lower associated sexual dysfunction and minimal weight gain. It has been recently proposed that atypical antipsychotics must show their efficacy in the treatment of depressive symptoms and cognitive deficits associated to schizophrenia. According to these criteria the following drugs are considered as atypical antipsychodcs: risperidone, olanzapine, quetiapine, ziprasidone, amisulpride, zotepine, iloperidone, aripiprazole and clozapine. These properties offer advantages over conventional antipsychotics, nevertheless, atypical antipsychotics have been associated with some adverse effects such as neuroleptic malignant syndrome, cardiovascular effects, weight gain, prolactin elevation, diabetes mellitus and hyperlipidemia, which are summarized in this review.
Filiaciones:
García-Anaya M.:
Subdireccion de Invest. Clinicas, Inst. Nac. de Psiq. R. de la Fuente, Calzada México-Xochimilco 101, San Lorenzo Huipulco, Tlalpan 14370, Mexico
Apiquian R.:
Subdireccion de Invest. Clinicas, Inst. Nac. de Psiq. R. de la Fuente, Calzada México-Xochimilco 101, San Lorenzo Huipulco, Tlalpan 14370, Mexico
Fresán A.:
Subdireccion de Invest. Clinicas, Inst. Nac. de Psiq. R. de la Fuente, Calzada México-Xochimilco 101, San Lorenzo Huipulco, Tlalpan 14370, Mexico
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