Pharmacological considerations in antipsychotic drug selection for prevention of drug-induced dysphagia.

Antipsychotic drugs have the ability to induce dysphagia. The aim of this study was to determine the association between the receptor affinity of antipsychotic drugs and the time-to-onset of dysphagia, and to identify factors that prevent antipsychotic drug-induced dysphagia. We used the receptor affinity of 13 antipsychotic drugs for which data were reported in an test using human receptors, extracted time-to-onset dysphagia from the Japan Adverse Drug Event Report database, and used data from 46 patients to evaluate the correlation between receptor affinity and time-to-onset of dysphagia. We found a negative correlation between D₂ receptor affinity and time-to-onset of dysphagia ( = -0.4572, = 0.0016), and a positive correlation between H, M, and M₃ receptor affinity and time-to-onset of dysphagia ( = 0.5006, = 0.0006; = 0.4130, = 0.0059; and = 0.4149, = 0.0057, respectively). Antipsychotic drugs with a strong D₂ receptor-blocking action may accelerate the onset of dysphagia, whereas a strong H, M, and M₃ receptor-blocking action may delay the onset of dysphagia. The current study revealed the relationship between the receptor affinity of antipsychotic drugs and the time-to-onset of dysphagia, which should aid in the selection of antipsychotic drugs, while preventing dysphagia.