Is the ideal antipsychotic a soloist or a member of a large ensemble? The earliest antipsychotic melody of D2 receptor antagonism was embedded in a cacophony of jackhammering antihistamines, screeching anticholinergics, and droning α-antagonists. This molecular noise is somewhat filtered by high-potency antipsychotics, but the emerging dopamine antagonist theme song is too loud, grating on nerves, especially extrapyramidal ones.
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