D1 antagonist
D1 dopamine receptor antagonist
- Little EPS (extrapyramidal symptoms) compared with D2 blockade
- May worsen cognition/negative symptoms by reducing cortical D1 tone
- Not associated with EPS (which is overwhelmingly D2-mediated)
- Theoretical contribution to motor slowing if combined with D2 blockade
- Would theoretically worsen negative symptoms and cognition
- D1 blockade occurs incidentally with some antipsychotics but is not a therapeutic target
- Could theoretically attenuate stimulant benefit for ADHD
Drugs with this mechanism (2)
- Loxapine inhaled — Inhaled loxapine for acute agitation; single-use inhaler under a bronchospasm REMS.
- Loxapine — Mid-potency typical; an inhaled form treats agitation.
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