Mechanisms of action

Question 1

Amisulpride

Answer 1

D2 & D3 antagonism

Question 2

Cariprazine

Answer 2

Partial dopamine agonist at D2. 5HT1A agonist & 5HT2A antagonist

Question 3

Aripiprazole

Answer 3

Partial dopamine agonist at D2 (post synaptic D2 receptors and presynaptic auto receptors). 5HT2A antagonist.

Question 4

What does the ‘Goldilocks phenomenon’ refer to with aripiprazole?

Answer 4

Antagonises excessive dopamine at mesolimbic zone, whilst mimicking dopamine at deficient mesocortical areas (-ve symptoms)

Question 5

Chlorpromazine & promazine

Answer 5

D2 blockade & antimuscarinic

Question 6

Clozapine

Answer 6

5HT2 & D2 blockade (weak D1 and D2 affinity). Also D4 and 5HT6. Alpha-1 antagonism & anticholinergic and antihistaminic properties.

Question 7

Lorasidone

Answer 7

D2 antagonist & 5HT2A blockers. Higher affinity for 5HT7 and partial 5HT1A agonist.

Question 8

Olanzapine

Answer 8

High 5HT2:D2 blockade ratio. Also D4 and 5HT6. Anticholinergic effects.

Question 9

Paliperidone

Answer 9

Metabolite of Risperidone

Question 10

Quetiapine

Answer 10

D2 blockade. Slightly less 5HT2A. Significant anticholinergic effect.

Question 11

Risperidone

Answer 11

Serotonin-Dopamine antagonist. High 5HT2A antagonism.

Question 12

Sulpiride

Answer 12

Purely D2 antagonism (low doses presynaptic, high doses postsynaptic)

Question 13

Thioridazine

Answer 13

D2 antagonist. Antimuscarinic effects.

Question 14

Agomelatine

Answer 14

5-HT2C antagonism