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Extra info for From Neurobiology to Treatment: Bipolar Disorder and Schizophrenia Unraveled
C) As represented by the inverted U-shaped curve, moderation is preferable when it comes to receptor stimulation. Too much or too little stimulation is suboptimal. Thus in order to reach the optimal tuning of the signal-to-noise ratio it is important to determine where the system is on the curve, as it might need to be either increased or decreased. 30 Chapter 3 /LWKLXP DQG 2WKHU $QWLFRQYXOVDQWV IRU WKH 7UHDWPHQW RI %LSRODU 'LVRUGHUV Chapter 3 aims to describe the complex pharmacology of mood stabilizers used to treat bipolar disorders.
That is, DA acts as the ultimate agonist and is too “hot,” resulting in psychosis (A). D2 blockers such as conventional antagonists are too “cold,” and while they prevent psychotic episodes they also lead to extrapyramidal side effects (EPS) (B). Partial agonists are “lukewarm,” leading to just the right stimulation of DA receptors, thus preventing psychotic episodes without inducing EPS (C). (Right) In terms of output, DA is the ultimate full agonist, leading to full receptor output (D). At the other end of the spectrum, conventional antipsychotics (full antagonists) lead to only very little DA output (E).
The D2 partial agonist aripiprazole is also an antagonist at 5HT2A receptors and a partial agonist at 5HT1A receptors. Besides being a D2 partial agonist, bifeprunox is also a partial agonist at the 5HT1A receptor. These additional properties are what make these compounds different from each other, and explains their different effectiveness in various individuals with specific ailments. 57 Bipolar Disorder and Schizophrenia Unraveled Properties of Atypical Antipsychotics: Part 1 Quetiapine has widespread actions on serotonin (5HT), dopamine (DA), and norpeinephrine (NE) systems.