UBC Faculty Research and Publications

How well do you know your dopamine antagonists? University of British Columbia. Therapeutics Initiative


Background: Therapeutics Letter 139 aims to provide clinicians with an understanding of dopamine (DA) antagonists and their potential side effects. Dopamine antagonists are a class of drugs commonly used to treat various psychiatric disorders, such as schizophrenia and bipolar disorder. Methods: The authors reviewed the literature on dopamine antagonists and their side effects, summarized the mechanism of action of dopamine antagonists, their clinical uses, and the different classes of dopamine antagonists. A clinical pharmacological approach was used to review how people may be harmed by DA antagonists. Videos included with this Letter may help clinicians and students better understand the potential harms of this drug class. Results: The article highlights the different types of DA antagonists and their respective side effects. It notes that some dopamine antagonists can cause metabolic disturbances, such as weight gain and hyperglycemia. Movement disorders, such as Parkinsonism and tardive dyskinesia, are also common side effects. Moreover, some dopamine antagonists can have cardiac effects, such as QT prolongation and torsades de pointes. Conclusions: Clinicians should be aware of the potential harms associated with these drugs, especially metabolic, movement, and cardiac effects and should learn and teach the symptoms and signs of dopamine blockade. The potential benefits and risks of dopamine antagonists should be carefully weighed when considering their use and patients should be re-examined frequently during treatment, with dose and duration of treatment re-assessed when renewing prescriptions.

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