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Conventional antipsychotics are best known for the treatment and maintenance of the psychotic (also known as positive) symptoms of schizophrenia. The major putative mechanism of action is via D2 blockade of the mesolimbic and mesocortical tracts. In many individuals, this blockade results in a measurable decrease in the positive symptoms of schizophrenia, including hallucinations, delusions, and behavioral disorganization. However, negative and cognitive symptoms of schizophrenia respond less robustly. In fact, they may be worsened by blockade of mesocortical tracts that play roles in cognition and hedonic reinforcement.

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FIGURE 27–3. Clinical benefits of low extrapyramidal side effect (EPS) risk.

FIGURE 27–4. Dose–response curves of classic versus atypical antipsychotic agents for antipsychotic effects versus extrapyramidal side effects.Source. Adapted from Jibson and Tandon 1998.
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TABLE 27–2. Comparison of CUtLASS band I and CATIE phase I

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