Pharmacologie et mode d'action des neuroleptiques

Neuroleptic treatments act on dopaminergic systems that play a role in perception modulation, control of emotions, motivation, and organization of adaptative behavior. These features are impaired in schizophrenia, which represents the first indication for neuroleptic treatment. Dopaminergic systems have also a role in motor control and inhibition of prolactin secretion. The antagonist action of these effects by neuroleptic agents generates side effects. Neuroleptics have not only antipsychotic and sedative effects (effects on hallucinations, delusions and agitation), but also desinhibitory and antideficit properties (effects on negative symptoms of schizophrenia). About ten principal classes of neuroleptics exist, depending on their biochemical structure. In terms of side effects, the second generation of neuroleptics drugs (generally not associated with extrapyramidal syndrome at their therapeutic dosage) differs from first generation neuroleptics which are frequently associated with extrapyramidal syndrome, even at therapeutic dosage.