Deutch A Y, Moghaddam B, Innis R B, Krystal J H, Aghajanian G K, Bunney B S, Charney D S
Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510.
Schizophr Res. 1991 Mar-Apr;4(2):121-56. doi: 10.1016/0920-9964(91)90030-u.
The mechanisms which contribute to the actions of atypical antipsychotic drugs, such as clozapine and the putative atypical agents remoxipride and raclopride, are reviewed. Examination of available preclinical and clinical data leads to two hypotheses concerning the mode of action of atypical antipsychotic drugs. The first hypothesis is that antagonism of the dopamine D2 receptor is both necessary and sufficient for the atypical profile, but that interaction with subtypes of the D2 receptor differentiates typical from atypical antipsychotic drugs. The second hypothesis has been previously advanced, and suggests that a relatively high ratio of serotonin 5-HT2:dopamine D2 receptor antagonism may subserve the atypical profile. It seems likely that the atypical antipsychotic drug profile may be achieved in more than one way.
本文综述了非典型抗精神病药物（如氯氮平以及假定的非典型药物瑞莫必利和雷氯必利）发挥作用的机制。对现有临床前和临床数据的研究得出了关于非典型抗精神病药物作用方式的两种假说。第一种假说是，多巴胺D2受体拮抗作用对于非典型药物特征而言既是必要的也是充分的，但与D2受体亚型的相互作用使典型抗精神病药物与非典型抗精神病药物区分开来。第二种假说是先前提出的，认为5-羟色胺5-HT2与多巴胺D2受体拮抗作用的相对高比例可能有助于形成非典型药物特征。非典型抗精神病药物特征似乎可能通过不止一种方式实现。
