Abstract
Schizophrenia is a chronic and severe psychiatric disease with various symptoms and poor prognosis. Antipsychotics are produced to reduce psychotic symptoms such as hallucinations and delusions at first. First-generation antipsychotics were produced in early period. They had antagonistic effect to dopamine pathway in whole brain, they could induce severe side effects such as extrapyramidal symptoms. Second-generation antipsychotics were latterly produced in order to reduce side effects, keeping effects toward psychotic symptoms. They have complex function related to serotonin receptors, or dopamine partial agonist. They succeeded to reduce extrapyramidal symptoms, but they had another metabolic side effects such as weight gain, obesity, and diabetes mellitus. Second-generation antipsychotics are recommended as the first line to treat schizophrenia in these days. When a person has the onset of schizophrenia, antipsychotics should be started as soon as possible. Drugs should be started in low dose at first, then increased gradually up to minimum dose with sufficient effect. Careful monitoring of symptoms and side effects are very important. Antipsychotics have various dosing type (injection, liquid, sublingual, and so on) for the various purpose. Second-generation antipsychotics are used not only for schizophrenia but also other psychiatric diseases like mood disorder, mainly due to the function in serotonin receptor. Other neural receptors different from dopamine and serotonin are also assumed related to pathophysiology of schizophrenia. Next-generation antipsychotics not related to dopamine receptor might be produced in the future.
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References
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed: American Psychiatric Association; 2013.
Boyd-Kimball D, Gonczy K, Lewis B, Mason T, Siliko N, Wolfe J. Classics in chemical neuroscience: chlorpromazine. ACS Chem Neurosci. 2019;10(1):79–88. https://doi.org/10.1021/acschemneuro.8b00258.
Correll CU, Citrome L, Haddad PM, Lauriello J, Olfson M, Calloway SM, et al. The use of long-acting injectable antipsychotics in schizophrenia: evaluating the evidence. J Clin Psychiat. 2016;77(suppl 3):1–24. https://doi.org/10.4088/JCP.15032su1.
Forsman J, Taipale H, Masterman T, Tiihonen J, Tanskanen A. Adherence to psychotropic medication in completed suicide in Sweden 2006–2013: a forensic-toxicological matched case-control study. Eur J Clin Pharmacol. 2019;75(10):1421–30. https://doi.org/10.1007/s00228-019-02707-z.
Fujii K, Ozeki Y, Okayasu H, Takano Y, Shinozaki T, Hori H, et al. QT is longer in drug-free patients with schizophrenia compared with age-matched healthy subjects. PLoS One. 2014;9(6):e98555. https://doi.org/10.1371/journal.pone.0098555.
Hocking CM, Kichenadasse G. Olanzapine for chemotherapy-induced nausea and vomiting: a systematic review. Support Care Cancer. 2014;22(4):1143–51. https://doi.org/10.1007/s00520-014-2138-y.
Holt RIG. Association between antipsychotic medication use and diabetes. Curr Diab Rep. 2019;19(10):96. https://doi.org/10.1007/s11892-019-1220-8.
Howes OD, McCutcheon R, Owen MJ, Murray RM. The role of genes, stress, and dopamine in the development of schizophrenia. Biol Psychiatry. 2017;81(1):9–20. https://doi.org/10.1016/j.biopsych.2016.07.014.
Huhn M, Nikolakopoulou A, Schneider-Thoma J, Krause M, Samara M, Peter N, et al. Comparative efficacy and tolerability of 32 oral antipsychotics for the acute treatment of adults with multi-episode schizophrenia: a systematic review and network meta-analysis. Lancet (London, England). 2019;394(10202):939–51. https://doi.org/10.1016/s0140-6736(19)31135-3.
International Association for Child and Adolescent Psychiatry and Allied Professions. e-Textbook of Child and Adolescent Mental Health. https://iacapap.org/iacapap-textbook-of-child-and-adolescent-mental-health/. Accessed 17 Nov 2020.
International Classification of Disease 10th. World Health Organization. https://icd.who.int/browse10/2019/en#/F20-F29. Accessed 17 Nov 2020.
International Classification of Disease 11th. World Health Organization. https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1683919430. Accessed 17 Nov 2020.
Kusumi I, Boku S, Takahashi Y. Psychopharmacology of atypical antipsychotic drugs: from the receptor binding profile to neuroprotection and neurogenesis. Psychiatry Clin Neurosci. 2015;69(5):243–58. https://doi.org/10.1111/pcn.12242.
Lally J, MacCabe JH. Antipsychotic medication in schizophrenia: a review. Br Med Bull. 2015;114(1):169–79. https://doi.org/10.1093/bmb/ldv017.
Leucht S, Cipriani A, Spineli L, Mavridis D, Orey D, Richter F, et al. Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis. Lancet (London, England). 2013;382(9896):951–62. https://doi.org/10.1016/s0140-6736(13)60733-3.
MacKenzie NE, Kowalchuk C, Agarwal SM, Costa-Dookhan KA, Caravaggio F, Gerretsen P, et al. Antipsychotics, metabolic adverse effects, and cognitive function in schizophrenia. Front Psych. 2018;9:622. https://doi.org/10.3389/fpsyt.2018.00622.
Marder SR, Cannon TD. Schizophrenia. N Engl J Med. 2019;381(18):1753–61. https://doi.org/10.1056/NEJMra1808803.
McCutcheon RA, Abi-Dargham A, Howes OD. Schizophrenia, dopamine and the striatum: from biology to symptoms. Trends Neurosci. 2019;42(3):205–20. https://doi.org/10.1016/j.tins.2018.12.004.
Meltzer HY. What’s atypical about atypical antipsychotic drugs? Curr Opin Pharmacol. 2004;4(1):53–7. https://doi.org/10.1016/j.coph.2003.09.010.
National Institute for Health and Care Excellence guidance. Psychosis and schizophrenia in adults. https://www.nice.org.uk/guidance/qs80. Accessed 17 Nov 2020.
Nielsen RE, Uggerby AS, Jensen SO, McGrath JJ. Increasing mortality gap for patients diagnosed with schizophrenia over the last three decades – a Danish nationwide study from 1980 to 2010. Schizophr Res. 2013;146(1–3):22–7. https://doi.org/10.1016/j.schres.2013.02.025.
Owen MJ, Sawa A, Mortensen PB. Schizophrenia. Lancet (London, England). 2016;388(10039):86–97. https://doi.org/10.1016/s0140-6736(15)01121-6.
Pillinger T, Beck K, Gobjila C, Donocik JG, Jauhar S, Howes OD. Impaired glucose homeostasis in first-episode schizophrenia: a systematic review and meta-analysis. JAMA Psychiat. 2017;74(3):261–9. https://doi.org/10.1001/jamapsychiatry.2016.3803.
Sadock BJ, et al. Kaplan & Sadock’s synopsis of psychiatry: behavioral sciences/clinical psychiatry. 11th ed. Philadelphia: Wolters Kluwer; 2015.
Stahl SM. Stahl’s essential psychopharmacoligy: neuroscientific basis and practical applications. 4th ed: Cambridge University Press; 2015.
Sugai T, Suzuki Y, Yamazaki M, Shimoda K, Mori T, Ozeki Y, et al. Difference in prevalence of metabolic syndrome between Japanese outpatients and inpatients with schizophrenia: a nationwide survey. Schizophr Res. 2016;171(1–3):68–73. https://doi.org/10.1016/j.schres.2016.01.016.
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Matsuzaka, Y., Kanegae, S., Ozawa, H. (2021). Antipsychotics/Neuroleptics: Definition, Classification, Indications and Differential Indications. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-319-56015-1_51-1
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