Again the benefits are the numbers of patients who can be assessed at any time as well as the ease of gathering and verifying the data. This system will be of greater initial utility in North America where a greater number of homes are connected to the Internet. However, it is likely that Europe will catch up in a few years and a second methodology for the remote assessment of cognitive Inhibitors,research,lifescience,medical function will be available. Selected abbreviations and acronyms AD Alzheimer’s disease ADAS Alzheimer’s Disease Assessment Scale CDR Cognitive Drug Research [system] CFF critical flicker fusion CRT choice reaction time
DC disturbance of consciousness DLB dementia with Lewy bodies DSST Digit Symbol Substitution Test GABA gamma-aminobutyric acid 5-HT 5-hydroxytryptamine
Several different classes of antipsychotic medications have been reliably shown to reduce active psychotic symptoms in schizophrenia and other psychoses1; all Inhibitors,research,lifescience,medical these drugs block the D2 family of dopamine receptors. Unfortunately,
the drug action is accompanied by side effects, which have inevitably limited their use. The first antipsychotic drug, chlorpromazin, was discovered serendipitously by Delay and Deniker,2 who were testing preanesthetic agents in schizophrenia for their “calming” action. Shortly after their discovery, a mechanism of action was proposed,3 and subsequently many similar drugs were synthesized Inhibitors,research,lifescience,medical and marketed; these are called traditional or first-generation antipsychotics.
Between 1975 and 1990, almost no new drug discovery occurred in schizophrenia. Then, in the 1990s, a second generation of antipsychotic drugs was Inhibitors,research,lifescience,medical developed – drugs with at least the same, possibly greater, antipsychotic action, but with significantly reduced motor side effects.4 The loss of motor side effects has produced a generation of medications far better tolerated by psychotic patients, and thus critically improving compliance. These secondgeneration drugs still possess the ability to block the D2 family of dopamine receptors, but have broader receptor affinity profiles, particularly affinity at the serotonin-2 Inhibitors,research,lifescience,medical (5 -hydroxy tryptamine-2 [5-HT2]) receptors. The mechanism of the antipsychotic action of these drug families certainly involves blockade of the D2 dopamine receptor. However, the mechanism whereby the brain translates this primary antidopaminergic action into a reduction in psychosis TCL remains unclear. Moreover, the additional new “ingredients” of action in the secondgeneration drugs also remain obscure, although 5-HT2 receptor antagonism has been often invoked.5 Recently, new Sirtuin protein technologies have been applied to human brain research to address these important questions, and the results have been supplemented by data from new directions in animal pharmacology. This paper will review the new antipsychotic agents, and then propose an overall mechanism of antipsychotic action.