Antipsychotic drugs at 75: the past, present, and future of psychosis management.
Level 5 - mechanism / opinion, no new human data
Narrative review and historical overview without systematic review methodology or primary data
PubMed 41052274 · doi:10.1093/bmb/ldaf016
What was done
This narrative review synthesized findings from clinical trials, neurobiological studies, and pharmacological literature spanning 75 years of antipsychotic development, tracking the evolution from the introduction of chlorpromazine to emerging non-dopaminergic mechanisms.
What was found
The abstract reports no numerical data, sample sizes, or effect estimates. It summarizes qualitative conclusions: standard dopamine D2 receptor antagonists effectively reduce positive symptoms but show limited efficacy for cognitive and negative symptoms; clozapine remains the gold standard for treatment-resistant schizophrenia; the traditional typical versus atypical dichotomy is increasingly outdated; and novel non-dopaminergic agents (such as the muscarinic agonist combination xanomeline-trospium) represent emerging therapeutic strategies.
Why it matters
It outlines the limitations of 75 years of dopamine-centric pharmacotherapy and contextualizes the ongoing clinical transition toward non-dopaminergic pathways and precision psychiatry in schizophrenia.
Limits
The abstract describes a broad narrative synthesis rather than a systematic review or meta-analysis, with no defined search protocol, quality assessment, or quantitative pooling. No specific study counts or patient cohorts are reported.
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