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The atypical antipsychotics (AAP), also known as second generation antipsychotics (SGAs) and serotonin–dopamine antagonists (SDAs), [1] [2] are a group of antipsychotic drugs (antipsychotic drugs in general are also known as tranquilizers and neuroleptics, although the latter is usually reserved for the typical antipsychotics) largely introduced after the 1970s and used to treat psychiatric ...
These side effects are serious and some of them are permanent, and many remain a crucial concern for companies and healthcare professionals and substantial efforts are being encouraged to reduce the potential risks for future antipsychotics through more clinical trials and drug development.
The difference between first- and second-generation antipsychotics is a subject of debate. The second-generation antipsychotics are generally distinguishable by the presence of 5HT2A receptor antagonism and a corresponding lower propensity for extrapyramidal side effects compared to first-generation antipsychotics. [15]
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First generation antipsychotics are used to treat schizophrenia and are often accompanied by extrapyramidal side effects. [1] They inhibit dopaminergic neurotransmission in the brain by blocking about 72% of the D2 dopamine receptors. [15] They can also block noradrenergic, cholinergic, and histaminergic activity. [15]
Certain second-generation antipsychotics, such as lurasidone and the partial D2-agonist aripiprazole, are more likely to cause akathisia compared to other second-generation antipsychotics. [12] If akathisia occurs, switching to an antipsychotic with a lower risk of akathisia may improve symptoms. [13]