All antipsychotics have actions at dopamine-2 receptors, but the atypical agents behave differently than the conventional antipsychotics at those receptors. In addition, the atypical antipsychotics block serotonin-2 receptors. These differences in receptor-binding profiles provide the basis for 2 theories that explain why the 2 classes of antipsychotics are similar in efficacy but different in side effect profile, especially in their propensity to cause motor side effects such as extrapyramidal symptoms and tardive dyskinesia.
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