New Atypical Antipsychotics in the Treatment of Schizophrenia and Depression

Overview

Journal Int J Mol Sci

Publisher MDPI

Specialties Biochemistry
Chemistry
Molecular Biology

Date 2022 Sep 23

PMID 36142523

Authors

Jolanta Orzelska-Gorka

Joanna Mikulska

Anna Wiszniewska

Grazyna Biala

Affiliations

Soon will be listed here.

Abstract

Schizophrenia and depression are heterogeneous disorders. The complex pathomechanism of the diseases imply that medication responses vary across patients. Many psychotropic drugs are available but achieving optimal therapeutic effect can be challenging. The evidence correlates well with clinical observations, suggesting that new atypical antipsychotic drugs are effective against negative and cognitive symptoms of schizophrenia, as well as against affective symptoms observed in depression. The purpose of this review presents the background and evidence for the use of the new second/third-generation antipsychotics (aripiprazole, cariprazine, lurasidone, asenapine, brexpiprazole, lumateperone, pimavanserin) in treatment of schizophrenia and depression. We have first provided a brief overview of the major neurobiological underpinnings of schizophrenia and depression. We then shortly discuss efficacy, safety and limitations of ongoing pharmacotherapy used in depression and schizophrenia. Mainly, we have focused this review on the therapeutic potential of new atypical antipsychotic drugs-currently existing-to be effective in psychotic, as well as in affective disorders.

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References

Loebel A, Cucchiaro J, Silva R, Kroger H, Sarma K, Xu J . Lurasidone as adjunctive therapy with lithium or valproate for the treatment of bipolar I depression: a randomized, double-blind, placebo-controlled study. Am J Psychiatry. 2013; 171(2):169-77. DOI: 10.1176/appi.ajp.2013.13070985. View

Meltzer H, Mills R, Revell S, Williams H, Johnson A, Bahr D . Pimavanserin, a serotonin(2A) receptor inverse agonist, for the treatment of parkinson's disease psychosis. Neuropsychopharmacology. 2009; 35(4):881-92. PMC: 3055369. DOI: 10.1038/npp.2009.176. View

Grace A, Gomes F . The Circuitry of Dopamine System Regulation and its Disruption in Schizophrenia: Insights Into Treatment and Prevention. Schizophr Bull. 2018; 45(1):148-157. PMC: 6293217. DOI: 10.1093/schbul/sbx199. View

Gabriel F, Oliveira de Melo D, Fraguas R, Leite-Santos N, Mantovani da Silva R, Ribeiro E . Pharmacological treatment of depression: A systematic review comparing clinical practice guideline recommendations. PLoS One. 2020; 15(4):e0231700. PMC: 7173786. DOI: 10.1371/journal.pone.0231700. View

Tobias J, MERLIS S . Levodopa and schizophrenia. JAMA. 1970; 211(11):1857. View

Slifirski G, Krol M, Turlo J . 5-HT Receptors and the Development of New Antidepressants. Int J Mol Sci. 2021; 22(16). PMC: 8396477. DOI: 10.3390/ijms22169015. View

Calabrese F, Tarazi F, Racagni G, Riva M . The role of dopamine D receptors in the mechanism of action of cariprazine. CNS Spectr. 2019; 25(3):343-351. DOI: 10.1017/S109285291900083X. View

Angrist B, Sathananthan G, Wilk S, Gershon S . Amphetamine psychosis: behavioral and biochemical aspects. J Psychiatr Res. 1974; 11:13-23. DOI: 10.1016/0022-3956(74)90064-8. View

Martinowich K, Lu B . Interaction between BDNF and serotonin: role in mood disorders. Neuropsychopharmacology. 2007; 33(1):73-83. DOI: 10.1038/sj.npp.1301571. View

10.

Plosker G, Deeks E . Asenapine: A Review in Schizophrenia. CNS Drugs. 2016; 30(7):655-66. DOI: 10.1007/s40263-016-0363-2. View

11.

Carbon M, Correll C . Thinking and acting beyond the positive: the role of the cognitive and negative symptoms in schizophrenia. CNS Spectr. 2014; 19 Suppl 1:38-52. DOI: 10.1017/S1092852914000601. View

12.

Loebel A, Cucchiaro J, Silva R, Kroger H, Hsu J, Sarma K . Lurasidone monotherapy in the treatment of bipolar I depression: a randomized, double-blind, placebo-controlled study. Am J Psychiatry. 2013; 171(2):160-8. DOI: 10.1176/appi.ajp.2013.13070984. View

13.

Grinchii D, Dremencov E . Mechanism of Action of Atypical Antipsychotic Drugs in Mood Disorders. Int J Mol Sci. 2020; 21(24). PMC: 7765178. DOI: 10.3390/ijms21249532. View

14.

Lenze E, Mulsant B, Blumberger D, Karp J, Newcomer J, Anderson S . Efficacy, safety, and tolerability of augmentation pharmacotherapy with aripiprazole for treatment-resistant depression in late life: a randomised, double-blind, placebo-controlled trial. Lancet. 2015; 386(10011):2404-12. PMC: 4690746. DOI: 10.1016/S0140-6736(15)00308-6. View

15.

Frampton J . Brexpiprazole: A Review in Schizophrenia. Drugs. 2019; 79(2):189-200. DOI: 10.1007/s40265-019-1052-5. View

16.

Kahn R, Sommer I . The neurobiology and treatment of first-episode schizophrenia. Mol Psychiatry. 2014; 20(1):84-97. PMC: 4320288. DOI: 10.1038/mp.2014.66. View

17.

Pourhamzeh M, Moravej F, Arabi M, Shahriari E, Mehrabi S, Ward R . The Roles of Serotonin in Neuropsychiatric Disorders. Cell Mol Neurobiol. 2021; 42(6):1671-1692. PMC: 11421740. DOI: 10.1007/s10571-021-01064-9. View

18.

Jha M, Fava M, Freeman M, Thase M, Papakostas G, Shelton R . Effect of Adjunctive Pimavanserin on Sleep/Wakefulness in Patients With Major Depressive Disorder: Secondary Analysis From CLARITY. J Clin Psychiatry. 2020; 82(1). DOI: 10.4088/JCP.20m13425. View

19.

Hall J, Thomas K, Everitt B . Rapid and selective induction of BDNF expression in the hippocampus during contextual learning. Nat Neurosci. 2000; 3(6):533-5. DOI: 10.1038/75698. View

20.

Pahwa M, Sleem A, Elsayed O, Good M, El-Mallakh R . New Antipsychotic Medications in the Last Decade. Curr Psychiatry Rep. 2021; 23(12):87. DOI: 10.1007/s11920-021-01298-w. View