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They offer reduced or absent EPS. With dopamine D2 and serotonin antagonism. More effective for negative symptoms (due to additional receptors).
Atypical/2nd Generation
Fast-acting Benzodiazepines
Is the most abundant amino acid in the CNS. Major excitatory neurotransmitter – high amounts might lead to seizure and stroke.
Glutamate
Amino acid with high concentrations in the brain and spinal cord. It acts as the major inhibitory neurotransmitter in the CNS. Crucial for the inhibition of excitatory neurons.
GABA
Responsible for the negative symptoms
Mesocortical
Medium-acting Benzodiazepines
Alprazolam- medium half-life
Lorazepam
Chlordiazepoxide
Synthesized by the enzyme acetyltransferase from the precursors acetyl-coenzyme A and choline
Acetylcholine
Very good treatment for mania, but has a lot of side effects. Work by affecting signal transduction through inhibition of second-messenger enzymes: Inositol monophosphate.
Lithium
Routine laboratory work-up before administration of Lithium:
Acts to diminish excessive neurotransmission by diminishing the
flow of ions through voltage-sensitive sodium channels. Enhances release of GABA thereby producing more neurotransmission. Acting through the complex transduction cascades.
Valproic Acid
Hypnotics in high doses however in lower doses they act as anxiolytics. Drugs of choice for management of acute anxiety and agitation.
Benzodiazepines
Extrapyramidal side effects
Nigrostriatal
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