A 34-year-old man was admitted to the psychiatric hospital because of an acute manic attack. The man had his first manic attack at the age of 27 and had three other manic attacks since then. A diagnosis of acute mania was made and a therapy was prescribed which included a drug that acts by blocking D2 an 5HT-2 receptors in the brain. Which of the following drugs was most likely prescribed?
A. Lamotigrine B. Clomipramine C. Valproate D. Olanzapine E. Lithium F. Trazodone
Olanzapine-learning objective: explain the mechanism of action of olanzapine.
an acute manic attack often requires a treatment with two or three drug combination, usually
lithium plus an anticonvulsant plus an atypical neuroleptic. all neuroleptics most likely act by
blocking d2 receptors in mesolimbic and mesocortical pathways. in addition they also block
5ht-2 receptors and this action may contribute to their clinical effects. atypical neuroleptics like
olanzapine seems to have higher affinity for 5ht-2 receptors than for d2 receptors.
a, b, c, e, f) all these drugs do not block both d2 and 5-ht2 receptors.