What is the primary mechanism of action for first-generation antipsychotics?

The primary mechanism of action for first-generation antipsychotics is the blockade of dopamine receptors, particularly the D2 subtype. These medications, often referred to as typical antipsychotics, were primarily developed to manage symptoms of schizophrenia and other psychotic disorders. By inhibiting dopamine transmission in certain areas of the brain, these drugs help alleviate the positive symptoms of psychosis, such as hallucinations and delusions, which are thought to be influenced by overactivity of dopaminergic pathways.

While serotonin receptors are targeted more by second-generation antipsychotics, the first-generation drugs focus predominantly on the dopaminergic system. The influence on other neurotransmitters such as norepinephrine or GABA is not the primary action of these medications and is more relevant to other classes of antidepressants or anxiolytics. Therefore, understanding that first-generation antipsychotics primarily work through dopamine receptor antagonism is crucial for grasping their therapeutic effects and potential side effects, including extrapyramidal symptoms due to dopamine pathway disruption.