Classifying Antipsychotic Agents

Need for New Terminology

Jindal, Ripu D
Keshavan, Matcheri S

¹ Department of Psychiatry, University of Ottawa School of Medicine, Ottawa, Ontario, Canada
² Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
³ Department of Psychiatry, Wayne State University, Detroit, Michigan, USA

Correspondence: Dr Ripu D. Jindal, Department of Psychiatry, University of Ottawa School of Medicine, 1355 Bank Street, Suite 208, Ottawa, ON K1H8K7, Canada. E-mail: [email protected]

CNS Drugs 22(12):p 1047-1059, December 01, 2008. | DOI: 10.2165/0023210-200822120-00007

Converging data from multiple lines of research provide growing understanding of the pharmacological basis of the efficacy and tolerability of antipsychotic agents. This review highlights some of the drawbacks of the current practice of classifying antipsychotic agents into first- and second-generation agents, and argues that much of what is known about an antipsychotic agent in terms of its efficacy and tolerability can be predicted from its binding affinity at different receptors. This makes a case for a new system of classification that reflects the receptor binding affinity profiles of individual antipsychotic agents. In its quest to make a compelling case, the review provides detailed explanations for the pharmacological basis of antipsychotic efficacy, antipsychotic-induced weight gain and diabetes mellitus, cognitive effects and other adverse effects.