ArticleCurrent neuropharmacology2009
Mechanisms of action of antipsychotic drugs of different classes, refractoriness to therapeutic effects of classical neuroleptics, and individual variation in sensitivity to their actions: Part I.
Article in Current neuropharmacology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 67 citations in OpenAlex.
- Increasing antipsychotic dose for non response in schizophrenia.The Cochrane database of systematic reviews · 2018Pooled it
- Increasing antipsychotic dose versus switching antipsychotic for non response in schizophrenia.The Cochrane database of systematic reviews · 2018Pooled it
- The prevalence of antipsychotic polypharmacy and its associations with violent behaviors among forensic psychiatry patients.BMC psychiatry · 2026Article
- Review
- An Emerging Prospective of Antipsychotics for Treating Neurodegenerative Disorders.Current pharmaceutical design · 2025Review
- On the improvement of schizophrenia detection with optical coherence tomography data using deep neural networks and aggregation functions.Scientific reports · 2024Article
- New studies with stable gastric pentadecapeptide protecting gastrointestinal tract. significance of counteraction of vascular and multiorgan failure of occlusion/occlusion-like syndrome in cytoprotection/organoprotection.Inflammopharmacology · 2024Review
- The relationship between serum prolactin levels and cognitive function in drug-naïve schizophrenia patients: a cross-sectional study.Journal of neural transmission (Vienna, Austria : 1996) · 2024Article
- Innate Vascular Failure by Application of Neuroleptics, Amphetamine, and Domperidone Rapidly Induced Severe Occlusion/Occlusion-like Syndromes in Rats and Stable Gastric Pentadecapeptide BPC 157 as Therapy.Pharmaceuticals (Basel, Switzerland) · 2023Article
- Neuropharmacological Effects of Terpenoids on Preclinical Animal Models of Psychiatric Disorders: A Review.Antioxidants (Basel, Switzerland) · 2022Review
- Peripheral biomarkers of treatment-resistant schizophrenia: Genetic, inflammation and stress perspectives.Frontiers in pharmacology · 2022Review
- G-protein coupled receptors and synaptic plasticity in sleep deprivation.World journal of psychiatry · 2021Review
- Cyclin D2 overexpression drives B1a-derived MCL-like lymphoma in mice.The Journal of experimental medicine · 2021Article
- Zebrafish disease models in drug discovery: from preclinical modelling to clinical trials.Nature reviews. Drug discovery · 2021Review
- The Antipsychotic Drug Clozapine Suppresses the RGS4 Polyubiquitylation and Proteasomal Degradation Mediated by the Arg/N-Degron Pathway.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2021Article
- Challenges of Delirium Management in Patients with Traumatic Brain Injury: From Pathophysiology to Clinical Practice.Current neuropharmacology · 2021Review
- Article
- Subcortical Dopamine and Cognition in Schizophrenia: Looking Beyond Psychosis in Preclinical Models.Frontiers in neuroscience · 2020Review
- Dopaminergic control of ADAMTS2 expression through cAMP/CREB and ERK: molecular effects of antipsychotics.Translational psychiatry · 2019Article
- Neural vulnerability factors for obesity.Clinical psychology review · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Many issues remain unresolved about antipsychotic drugs. Their therapeutic potency scales with affinity for dopamine D2 receptors, but there are indications that they act indirectly, with dopamine D1 receptors (and others) as possible ultimate targets. Classical neuroleptic drugs disinhibit striatal cholinergic interneurones and increase acetyl choline release. Their effects may then depend on stimulation of muscarinic receptors on principle striatal neurones (M4 receptors, with reduction of cAMP formation, for therapeutic effects; M1 receptors for motor side effects). Many psychotic patients do not benefit from neuroleptic drugs, or develop resistance to them during prolonged treatment, but respond well to clozapine. For patients who do respond, there is a wide (>ten-fold) range in optimal doses. Refractoriness or low sensitivity to antipsychotic effects (and other pathologies) could then arise from low density of cholinergic interneurones. Clozapine probably owes its special actions to direct stimulation of M4 receptors, a mechanism available when indirect action is lost.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.