Brainstorms September 15, 1997

"Awakening" From Schizophrenia: Intramolecular Polypharmacy and the Atypical Antipsychotics

Stephen M. Stahl

J Clin Psychiatry 1997;58(9):381-382

Article Abstract

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.