RT Journal Article SR Electronic T1 Inverse Agonist Activity of Atypical Antipsychotic Drugs at Human 5-Hydroxytryptamine2C Receptors JF Journal of Pharmacology and Experimental Therapeutics JO J Pharmacol Exp Ther FD American Society for Pharmacology and Experimental Therapeutics SP 226 OP 232 VO 295 IS 1 A1 Katharine Herrick-Davis A1 Ellinor Grinde A1 Milt Teitler YR 2000 UL http://jpet.aspetjournals.org/content/295/1/226.abstract AB Clozapine is the prototype atypical antipsychotic drug, producing little or no extrapyramidal side effects, while improving negative symptoms of psychosis. Clozapine's high affinity for serotonin receptors has been hypothesized to confer the unique antipsychotic properties of this drug. Recently, we demonstrated that both typical and atypical antipsychotic drugs are inverse agonists at constitutively active 5-hydroxytryptamine2A (5-HT2A) receptors. To determine whether inverse agonist activity at 5-HT2Creceptors plays a role in antipsychotic efficacy, typical and atypical antipsychotic drugs were tested for inhibition of basal inositol phosphate production in mammalian cells expressing rat or human 5-HT2C receptors. Atypical antipsychotic drugs (sertindole, clozapine, olanzapine, ziprasidone, risperidone, zotepine, tiospirone, fluperlapine, tenilapine) displayed potent inverse agonist activity at rat and human 5-HT2C receptors. Typical antipsychotic drugs (chlorpromazine, loxapine, thioridazine, prochlorperazine, perphenazine, mesoridazine, trifluperidol, fluphenazine, spiperone, haloperidol, pimozide, penfluridol, thiothixene) were devoid of inverse agonist activity, with the exception of loxapine. We review the evidence that loxapine has unique properties characteristic of both atypical and typical antipsychotic drugs. Several typical antipsychotic drugs (chlorpromazine, thioridazine, spiperone, thiothixene) displayed neutral antagonist activity by reversing clozapine inverse agonism. These data suggest that 5-HT2C inverse agonist activity is associated with atypical antipsychotic drugs with moderate to high affinity for 5-HT2C receptors, and imply that effects of atypical antipsychotic drugs on the 5-HT2C receptor may play a role in their unique clinical properties. These data also imply that dysfunction of brain 5-HT2C receptor systems may be one of the factors involved in the etiology of psychosis. The American Society for Pharmacology and Experimental Therapeutics