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High-dose antipsychotic medication

Published online by Cambridge University Press:  02 January 2018

A.V.P. Mackay
A.V.P. Mackay*
Affiliation:
University of Glasgow
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The dopamine hypothesis for the mode of action of antipsychotic drugs has been with us for some 30 years and has, by and large, withstood the test of time. It simply states that antipsychotic drugs owe their therapeutic effects to an ability to block central dopamine receptors. This has given us a working and testable explanation for the effects of these drugs and it has prompted the synthesis of new agents. While so-called antipsychotic drugs (otherwise known as neuroleptics or major tranquillisers) are known to be effective in schizophrenia and related psychoses, mania, and the agitation associated with severe depressive illness or organic disorder, this paper is only concerned with the pharmacotherapy of schizophrenia.

Type
Research Article
Information
Advances in Psychiatric Treatment , Volume 1 , Issue 1 , September 1994 , pp. 16 - 22
Copyright
Copyright © The Royal College of Psychiatrists 1994 

References

Baldessarini, R. & Frankenburg, F. R. (1991) Clozapine, a novel antipsychotic agent. New England Journal of Medicine, 324, 746–754.Google ScholarPubMed
Barnes, T. R. E. & Bridges, R. K. (1980) Disturbed behaviour induced with high dose antipsychotic drugs. British Medical Journal, 281, 274–275.Google Scholar
Farde, L., Wiesel, F.-A., Halldin, C. et al (1988) Central D2-dopamine receptor occupancy in schizophrenic patients being treated with antipsychotic drugs. Archives of General Psychiatry, 45, 71–76.Google Scholar
Farde, L., Nordstrom, A.-L., Wiesel, F.-A. et al (1992) Positron emission tomographic analysis of central D1 and D2 dopamine receptor occupancy in patients treated with classical neuroleptics and clozapine. Archives of General Psychiatry, 49, 538–544.Google Scholar
Hirsch, S. R. & Barnes, T. R. E. (1994) Clinical use of high dose neuroleptics. British Journal of Psychiatry, 164, 94–96.Google Scholar
Kane, J. M. (1994) The use of higher-dose antipsychotic medication. British Journal of Psychiatry, 164, 421–432.Google Scholar
Kane, J. M., Honigfeld, F., Singer, J. et al (1988) Clozapine for the treatment resistant schizophrenic: a double-blind comparison with chlorpromazine. Archives of General Psychiatry, 45, 789–796.Google Scholar
Leysen, J. E. (1993) Risperidone: receptor occupancy profile and pharmacological activity. Schizophrenia Review, 1, 9–10.Google Scholar
Leysen, J. E. & Niemegeers, C. J. E. (1985) Chapter 13. In Handbook of Neurochemistry, vol. 9 (ed. Lajtha, A.) New York: Plenum.Google Scholar
Leysen, J. E., Janssen, P. M. F., Gommeren, W. et al (1992a) In vitro and in vivo receptor binding and effects on monoamine turnover in rat brain regions of the novel antipsychotics risperidone and ocaperidone. Molecular Pharmacology, 41, 494–508.Google ScholarPubMed
Leysen, J. E., Janssen, P. M. F., Schotte, A. et al (1992b) Biological basis for 5HT2 antagonists as treatment of schizophrenia. Symposia Proceedings, 18th CINP Congress, pp. 10–11. Nice.Google Scholar
Mehtonen, O. P., Aranko, K., Malkonen, L. et al (1991) A study of sudden death associated with the use of antipsychotic or antidepressant drugs. Acta Psychiatrica Scandinavica, 84, 58–64.Google Scholar
Reynolds, G. (1992) Developments in the drug treatment of schizophrenia. Trends in Pharmacological Sciences, 13, 116–121.Google Scholar
Schotte, A., Janssen, P. F. M., Megens, A. A. H. P. et al (1993) Occupany of central neurotransmitters receptors by risperidone, clozapine and haloperidol measured ex vivo by quantitative autoradiography. Brain Research, 631, 191–202.CrossRefGoogle Scholar
Seeman, P. (1990) Atypical neuroleptics: the role of multiple receptors, endogenous dopamine and receptor linkage. Acta Psychiatrica Scandinavica, 82 (suppl. 358), 14–20.CrossRefGoogle Scholar
Seeman, P., Guan, H.-C. & Van Tol, H. H. (1993) Dopamine D4 receptors elevated in schizophrenia. Nature, 365, 441–445.Google Scholar
Simpson, G. M., Davis, J., Jefferson, J. W. et al (1987) Sudden Deaths in Psychiatric Patients: The Role of Neuroleptic Drugs. APA Task Force Report, No. 27. Washington, DC: APA.Google Scholar
Snyder, S. H., Greenberg, D. & Yamamura, H. I. (1974) Anti-schizophrenic drugs: affinity for muscarinic cholinergic receptor sites in the brain predicts extrapyramidal effects. Journal of Psychiatric Research, 11, 91–95.Google Scholar
Sokoloff, P., Giros, B., Martres, M.-P. et al (1990) Molecular cloning and characterisation of a novel dopamine receptor (D3) as a target for neuroleptics. Nature, 347, 146–151.CrossRefGoogle ScholarPubMed
Thompson, C. (1994) Consensus statement. The use of high-dose antipsychotic medication. British Journal of Psychiatry, 164, 448–458.Google Scholar
Van Tol, H. H. M., Bunzow, J. R., Guan, H.-C. et al (1991) Cloning of the gene for a human dopamine D4 receptor with high affinity for the antipsychotic clozapine. Nature, 350, 610–614.CrossRefGoogle ScholarPubMed
Wolkin, A., Brodie, J. D., Barouche, F. et al (1989a) Dopamine receptor occupancy and plasma haloperidol levels. Archives of General Psychiatry, 46, 482–483.CrossRefGoogle ScholarPubMed
Wolkin, A., Barouche, F., Wolf, A. P. et al (1989b) Dopamine blockade and clinical response: evidence for two biological subgroups of schizophrenia. American Journal of Psychiatry, 146, 905–908.Google Scholar
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