Kinon B J, Lieberman J A
Department of Psychiatry, Albert Einstein College of Medicine, Glen Oaks, NY 11004, USA.
Psychopharmacology (Berl). 1996 Mar;124(1-2):2-34. doi: 10.1007/BF02245602.
Various criteria used to define atypical antipsychotic drugs include: 1) decrease, or absence, of the capacity to cause acute extrapyramidal motor side effects (acute EPSE) and tardive dyskinesia (TD); 2) increased therapeutic efficacy reflected by improvement in positive, negative, or cognitive symptoms; 3) and a decrease, or absence, of the capacity to increase prolactin levels. The pharmacologic basis of atypical antipsychotic drug activity has been the target of intensive study since the significance of clozapine was first appreciated. Three notions have been utilized conceptually to explain the distinction between atypical versus typical antipsychotic drugs: 1) dose-response separation between particular pharmacologic functions; 2) anatomic specificity of particular pharmacologic activities; 3) neurotransmitter receptor interactions and pharmacodynamics. These conceptual bases are not mutually exclusive, and the demonstration of limbic versus extrapyramidal motor functional selectivity is apparent within each arbitrary theoretical base. This review discusses salient distinctions predominantly between prototypic atypical and typical antipsychotic drugs such as clozapine and haloperidol, respectively. In addition, areas of common function between atypical and typical antipsychotic drug action may also be crucial to our identification of pathophysiological foci of the different dimensions of schizophrenia, including positive symptoms, negative symptoms, and neurocognitive deficits.
1）导致急性锥体外系运动副作用（急性EPSE）和迟发性运动障碍（TD）的能力降低或缺失；2）阳性、阴性或认知症状改善所反映的治疗效果增强；3）升高催乳素水平的能力降低或缺失。自从氯氮平的重要性首次被认识以来，非典型抗精神病药物活性的药理学基础一直是深入研究的目标。在概念上，有三个概念被用来解释非典型与典型抗精神病药物之间的区别：1）特定药理功能之间的剂量反应分离；2）特定药理活性的解剖学特异性；3）神经递质受体相互作用和药效学。这些概念基础并非相互排斥，并且在每个任意的理论基础内，边缘系统与锥体外系运动功能选择性的表现都是明显的。本综述主要讨论分别作为典型非典型和典型抗精神病药物的氯氮平和氟哌啶醇之间的显著区别。此外，非典型和典型抗精神病药物作用之间的共同功能领域对于我们确定精神分裂症不同维度的病理生理焦点（包括阳性症状、阴性症状和神经认知缺陷）可能也至关重要。
