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Dr Stephen M. Stahl's presentation on Antipsychotic Medications (part 2 of 4)

Stahl 2

Dr Stahl MD, is a practicing psychiatrist in Carlsbad, USA, and the author of best-selling textbook, Essential Psychopharmacology. In this second video of a four-part series on Psychopharmacology he discusses receptor binding profiles of conventional versus atypical antipsychotic medications. The dopamine D2 and serotonin 5-HT2a antagonist properties of atypical antipsychotics will be reviewed, and additional binding properties of atypical antipsychotics will be demonstrated. Finally, differences in efficacy and tolerability of these antipsychotics is explained based on differences in the additional binding properties of these agents.

Dr. Stahl classifies atypical antipsychotics in 3 classes:
The “-pines” (clozapine, olanzapine, quetiapine, asenapine):

  • 60-80% D2 occupancy
  • quite some binding properties more potent than D2 binding
  • 5-HT2a binding is always more potent than D2 binding

The “-dones” (risperidone, paliperidone, ziprasidone, iloperidone, lurasidone):

  • fewer binding properties more potent than D2 binding
  • 5-HT2a binding is always more potent than D2 binding

The “-pips” (aripiprazole):

  • hardly any binding properties more potent than D2 binding
  • 5-HT2a binding is less potent than D2 binding

Suggested further reading:

View the next Dr Stahl Presentation here.

View the previous Dr Stahl Presentation here.

Download Dr Stahl's PDF Pocket Guide to Atypical Antipsychotics (Dosing, switching, and other practical information).

Download the Powerpoint presentation from Dr. Stahl's Psychopharmacology Workshop “Optimizing Care for Patients with Schizophrenia – Symptom, Circuits, and Neurotransmitters and the Antipsychotic Armamentarium”.