By F. Rahman
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1 5-HT2A Receptor Ligands Most attention has been paid to selective 5-HT2A receptor antagonists, inspired predominantly by the theory put forward by Meltzer and his colleagues that an increase in 5-HT2A binding over D2 binding leads to less EPS (see Sect. 3). However, although several ligands (with varying degree of selectivity over the 5-HT2C receptor) have been tried in schizophrenic patients, none have been found particularly effective in treating positive, negative or cognitive symptoms. Although these studies using inverse agonists such as pimavanserin (20, ACP-103) and nelotanserin (21, APD-125), or antagonists such as eplivanserin (22, SR-46349), volinanserin (23, MDL 100,907) and CYR-101 were generally found to be superior to placebo, they were invariably less effective than standard antipsychotics .
5 Summary In this chapter, we have tried to give an overview of the current status of antipsychotic treatment, highlighting the enormous validity of the current therapeutic arsenal, which has significantly reduced the burden of millions of patients. However, from Antipsychotics and the Dopamine–Serotonin Connection 39 our survey it is also clear that there is still room for significant improvement, especially in relation to the cognitive and negative symptoms, as well as overall compliance. As virtually all antipsychotics affect both DA and 5-HT receptors, we next discussed these two neurotransmitters and their interaction in some detail.
Schizophr Bull 39(6):1337–1342 36. Fineberg AM, Ellman LM, Buka S et al (2013) Decreased birth weight in psychosis: influence of prenatal exposure to serologically determined influenza and hypoxia. Schizophr Bull 39(5):1037–1044 37. Shamir EZ, Cassan SM, Levy A et al (2013) Biometric parameters of the hand as an index of schizophrenia-a preliminary study. Psychiatry Res 210(3):716–720 38. Isohanni M, Jones PB, Moilanen K et al (2001) Early developmental milestones in adult schizophrenia and other psychoses.
Avicenna's Psychology by F. Rahman