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International Journal Of Medical, Pharmacy And Drug Research(IJMPD)

Seven decades of Anti-Psychotic Drugs: A Review

Daisy , Rajesh Kumar , Ajeet Pal Singh , Amar Pal Singh , Prachi Sharma


International Journal of Medical, Pharmacy and Drug Research(IJMPD), Vol-8,Issue-2, April - June 2024, Pages 8-23 ,

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Article Info: Received: 07 Feb 2024; Received in revised form:15 Mar 2024; Accepted: 22 Mar 2024; Available online: 04 Apr 2024

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Since the discovery of the first effective antipsychotic medication (APM) in the mid 1950s, efforts to enhance their efficacy have been limited, despite improvements in tolerability. This stagnation is evident in effectiveness trials conducting in Europe and the United States. Several factors contribute to the failure to develop more effective APMs, including the absence of appropriate assessment tools for core symptoms domains in schizophrenia, reliance on the dopamenergic hypothesis, and the prolifration of “me too” drugs. The classification of APMs is also convoluted, grouping together second-generation, partial agonists, and multimodel APMs despite significant differences in their mechanism of action. Chllenges such as inadequate sample sizes, lack of statistical measures correlating with clinical significanse, and the high cost of newer APMs further hinder drug development. Additionally, there is lack of early predictors of antipsychotic response and tools to optimize APM efficacy. Suboptimal APM use by mental health providers, including excessive maintenance doses and irrational polypharmacy, exacerbates effectivness and medication adherence issues. Despite these challenges,there have been advancaments in APM tolerability and the development of long-acting injectables to address medication nonadherence. This critical review examines 70 years of antipsychotic development, identifies reasons for the failure to develop more effective APMs , and suggestes future directions in this field.

Antipsychotic Medication (APM), Efficacy Enhancement Efforts, Dopaminergic Hypothesis, Drug Classification, Medication Adherence Issues

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