All other authors have no conflicts of interest to declare. The Hub gives you an opportunity to make a difference.CONVENTIONAL OR TYPICAL OR FIRST GENERATION ANTIPSYCHOTICUNCONVENTIONAL OR ATYPICAL OR SECOND GENERATION ANTIPSYCHOTICS2. Submission guidelines for mcknights.com; Resources ... 2019 Antipsychotic rule loosened under CMS proposal ... prescriptions for antipsychotics … British Heart Rhythm Society Clinical Practice Guidelines on the Management of Patients Developing QT Prolongation on Antipsychotic Medication. 2012 Jun 1;35(6):459-70. doi: 10.2165/11598160-000000000-00000.Vieweg WV, Wood MA, Fernandez A, Beatty-Brooks M, Hasnain M, Pandurangi AK.Drugs Aging. The British Heart Rhythm Society's Disclosure: PDL is supported by UCLH Biomedicine NIHR. Indefinite continuation is recommended for patients with a history of suicide attempts … Atypical antipsychotics are also known as second generation antipsychotics. While they aim to treat psychosis through dopamine (D2) receptor antagonism in most cases, there are other antipsychotics with Clinicians should be familiar with the different receptor profiles which will enable them in individualising the choice of antipsychotic.Dr. 2018 Mar-Apr;59(2):105-122. doi: 10.1016/j.psym.2017.10.009. Please enable it to take advantage of the complete set of features! New atypical antipsychotic with 5HT2A and D2 antagonism, high affinity for 5HT7 and 5HT2A and moderate affinity for Alpha2 and 5HT1A receptors. Negligible histaminergic and muscarinic antagonism. 2009;26(12):997-1012. doi: 10.2165/11318880-000000000-00000.Beach SR, Celano CM, Sugrue AM, Adams C, Ackerman MJ, Noseworthy PA, Huffman JC.Psychosomatics. 1. Name must be less than 100 characters Radcliffe Cardiology Arrhythm Electrophysiol Rev. Radcliffe Cardiology However because the mesolimbic pathway is also a reward pathway, D2 antagonism can result in patients having apathy, anhedonia, and amotivation.When a typical antipsychotic which is a dopamine antagonist is prescribed, it cannot selectively block the D2 in the mesolimbic area while sparing the D2 receptors in other areas.Therefore, prescription of a D2 antagonist can block Dopamine receptors in other areas, resulting in side effects.The 5HT2A receptor can be considered to be a break on the Dopamine release, i.e., if the 5HT2A receptor is activated it blocks Dopamine release.Thus, 5HT2A antagonism stimulates Dopamine release in a range of pathways, thus reducing the side effects that a typical Dopamine blocker would cause.The atypical antipsychotics can be divided into the Below we cover the main receptor profiles of the different antipsychotics that are relevant to clinical practice as opposed to outlining every single receptor binding.This is relevant clinically as an understanding of receptor profiles can help choose antipsychotics with a lower propensity for side effects which in turn enhances compliance.5HT2C, M3 and H1 antagonism mediate metabolic side effects. Guidelines from the WFSBP 43 state that continuous antipsychotic treatment for at least 1 year is recommended in patients with first-episode psychosis, while in patients with previous history of multiple episodes, treatment should be maintained for 2–5 years, but both recommendations have a level C of evidence. We searched Embase, MEDLINE, PsycINFO, PubMed, BIOSIS, Cochrane Central Register of Controlled Trials (CENTRAL), WHO International Clinical Trials Registry Platform, and ClinicalTrials.gov from database inception to Jan 8, 2019. Another unknown receptor X may be involved.Olanzapine, Quetiapine, and Clozapine have greater cardiometabolic risks due to a strong affinity with the above receptors.On the other hand, Lurasidone, Aripiprazole, and Brexpiprazole have lower cardiometabolic risks due to low binding to the above receptors.Antipsychotic medications like Aripiprazole, Lurasidone, and Brexpiprazole have antidepressant effects due to 5HT7 and 5HT1A partial agonism and hence may be a better choice to treat depressive symptoms in schizophrenia.If sedation is required, then Quetiapine and Olanzapine have higher H1 antagonism which needs to be balanced against the risk of weight gain as the same receptor mediates both actions.Not all antipsychotic medications are the same. You an opportunity to make a difference.CONVENTIONAL OR TYPICAL OR FIRST GENERATION ANTIPSYCHOTICUNCONVENTIONAL OR atypical OR second GENERATION.... 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