antipsychotic-rainbow
TRANSCRIPT
Leah Wonderful, PharmD 2016
EFFICACY AND SAFETY OF ANTIPSYCHOTIC AGENTS BY RECEPTOR BINDING AFFINITY
RECEPTOR ANTOGONIZED
DOPAMINE SEROTONIN ADRENGIC MUSCARINIC HISTAMINE
D2 D3 5HT1a 5HT2a 5HT2c 5HT7 a1 M1 M3 H1
THERAPEUTIC EFFECTS
Reduced positive
symptoms
Reduced positive
and negative
symptoms
Reduced EPS & decreased
hyper prolactinemia, antidepressant
anxiolytic
Reduced EPS & decreased
hyper prolactinemia
Antidepressant improved
sleep
Reduced circadian rhythm
dysfunction and
negative symptoms, increased cognitive function
Reduced nightmares
Reduced EPS
Hypnotic
ADVERSE EFFECTS
EPS, increased
hyper prolactinemia,
negative symptoms, cognitive
deficits and sedation
Unknown Unknown Metabolic Metabolic Unknown Dizziness, sedation,
hypotension
Constipation, dry mouth,
blurred vision
Metabolic, sedation
Aripiprazole (Abilify®)
3PA* 3 3 2 2 3 2 0 0 2
Ziprasidone (Geodon®)
3 3 2PA* 4 4 3 2 0 0 2
Lurasidone (Latuda®)
3 0 3 2 1 2 3 0 0 0
Brexpiprazole (Rexulti®)
4PA* 3PA* 4PA* 4 1 1 4 0 0 2
Perphenazine 3 3 2 4 4 4 3 1 0 3
Asenapine (Saphris®)
4 4 1 3 1 2 1 0 0 3
Haloperidol (Haldol®)
3 2 0 1 0 0 2 0 0 0
Paliperidone (Invega®)
3 3 1 4 2 3 3 2 0 2
Iloperidone (Fanapt™)
3 2 2 3 1 2 3 0 0 2
Quetiapine (Seroquel®,
Seroquel XR®) 1 1 1 2 1 2 3 2 2 3
Risperidone (Risperdal® )
3 3 1 4 2 3 3 0 0 2
Olanzapine (Zyprexa®)
2 2 0 3 2 1 2 2 2 3
Clozapine (Clozaril®, FazaClo®)
1 1 1 2 2 2 3 3 2 3
BINDING AFFINITY
0 Ki>1,000 Very weak/none
1 1,000>Ki>100 Weak
2 100>Ki>10 Moderate
3 10>Ki>1 Strong
4 1>Ki Very strong *Denotes partial agonism