The dopamine dilemma: using stimulants and antipsychotics concurrently

Stimulant and antipsychotic medications are commonly used together without concern, despite their potentially opposing mechanisms. An examination of dopamine pathways and receptors suggests that concerns regarding interactions between these two classes are justified and relevant. Efficacy of concurrent use is reviewed for several indications, with a focus on comorbid attention deficit hyperactivity disorder and aggression. The risk of adverse reactions is examined. Complex dopamine mechanisms are considered to explain the dilemma, and general treatment guidelines for stimulant-antipsychotic concurrent use are discussed.