D1 and D5 activate adenylyl cyclase

while

D2, 3, and 4 inhibit adenylyl cyclase

dirty drug

H1 blocker: sedation

M blocker: dry mouth

D2 blocker: extrapyramidal anti-emetic, prolactin release

alpha blocker: hypotension (orthostatic), nasal congestion

Na and K block: 1a effect = QT prolongation

clean drug

high affinity for D2 receptor, less side effects, but more D2-mediated side effects

but causes Parkinson-like extrapyramidal rigidity, dystonic reaction and hypokinesia --> akinesia --> tremors --> akathisia --> tardive dyskinesia

iatrogenic

for treatment, use anti muscarinic - benztropine (atropine-like), trihexphenidyl, diphenhydramine, and amantadine

clozapine, risperidone, olanzapine, quetiapine, ziprasidone, sulpirid

do not work via dopamine receptors or cause extrapyramidal side effects

Low(er) affinity for D2
High affinity for D4
High affinity antagonism for 5-HT2

metabolism via 1A2

but: causes agranulocytosis, sedation, orthostasis, QT prolongation, hypersalivation, hyperthermia, seizures, weight gain, diabetogenic

clozapine w/o agranulocytosis and hypersalivation

otherwise very similar

5-HT2 > D2 blocker

can induce Parkinsonian side effects at high dose

5HT-2 antagonist

SNRI

QT prolongation

no other side effects known

bipolar disorder, schizophrenia

D2 blocker, GHB blocker, antidepressive

some parkinsonism, dose dependent

amisulpiride = same, w/o weight gain

sedating, cataracts, hypothyroidism

mixed drug