Current Antipsychotics

Six decades after the serendipitous discovery of chlorpromazine as an antipsychotic and four decades after the launch of clozapine, the first atypical or second generation antipsychotic, psychopharmacology has arrived at an important crossroad. It is clear that pharmacological research and pharmaceutical development must now focus on complementary or even alternative mechanisms of action to address unmet medical  needs, i.e. poorly treated domains of schizophrenia, improved acceptance by patients, better adherence to medication, safety in psychoses in demented patients, and avoiding cardiac and metabolic adverse effects. The first completely novel mechanisms evolving from our insights into the pathophysiology of psychotic disorders, especially the role of glutamatergic mechanisms in schizophrenia, are now under development, and further principles are on the horizon. This situation, in many respects similar to that when the initial second-generation antipsychotics became available, can be rewarding for all.  Preclinical and clinical researchers now have the opportunity to confirm their hypotheses and the pharmaceutical industry may be able to develop really novel classes of therapeutics.

Preface.- Dopaminergic dysfunction in psychotic disorders.- Role of dopamine D2 receptors for antipsychotic activity.- Dopamine receptor signaling pathways and antipsychotics.- Serotonergic mechanisms as targets for existing and novel antipsychotics.- Antipsychotics in the treatment of psychoses during development.- Weight gain and metabolic disturbances induced by antipsychotic treatments.- Medical needs in the treatment of psychotic disorders.- Antipsychotics in the treatment of bipolar disorders.- Pharmacogenomics of antipsychotics.- Drug interactions and drug monitoting of antipsychotics.- Delivery systems and dosing for antipsychotics.- Imaging as tool to investigate psychoses and antipsychotics.- Biomarkers for antipsychotic therapies.- Behavioral animal models of antipsychotic drug actions.