Combined antagonism of adrenoceptors and dopamine and 5-HT receptors underlies the atypical profile of clozapine.

Previous studies have shown that alpha 1-adrenoceptors, dopamine D1-like and 5-HT2A receptors play an important role in the effects of the atypical neuroleptic, clozapine, on the parameter modelling antipsychotic efficacy in the paw test. Therefore, it became of interest to investigate whether antagonism of all these receptors together would give rise to effects characteristic of clozapine. The effects of the combined administration of the alpha 1-adrenoceptor antagonist phenoxybenzamine, the dopamine D1 receptor antagonist, SCH 39166 (4-(4-chloro-3-methoxyphenyl)-1,2- dihydronaphthalene), and the 5-HT2A receptor antagonist, ketanserin, were therefore measured in the paw test. The present data show that all three drugs together, but not simply combinations of two out of three, produced a profile similar to that of clozapine: a significant increase in the parameter modelling antipsychotic efficacy and no change in the parameter modelling extrapyramidal side-effects.