Pharmacology of antipsychotic drugs

Data on the pharmacologic dissimilarities of antipsychotic drugs, and the clinical consequences of these differences, are reviewed briefly, with an emphasis on the interaction of these drugs with dopaminergic systems. Although differential anticholinergic activity has been proposed as an explanation for purported differences in the incidence of anticholinergic side effects of various neuroleptics, a more plausible explanation relates to site specificity. The so-called atypical neuroleptics show far less dopamine blocking potency in human striatum compared to haloperidol, with equal receptor blocking potency in the limbic system. The model of site-specificity will be of major importance in the development of future antipsychotics, with the goal of decreasing the incidence of side effects.