Dopamine Antagonists

Effects

Dopamine antagonists are antidopaminergic, antipsychotic, antiemetic, and prokinetic. They are antagonists at dopamine receptors, eg, dopamine (D2)-receptors, thus abolishing the effects of the neurotransmitter dopamine.

Indications

  • Psychotic disorders
  • Nausea and vomiting, to promote gastric emptying and motility in the gastrointestinal tract.
  • Some dopamine antagonists are also used to treat movement disorders (dyskinesias, including neuroleptic-induced), e.g., tiapride (Tiapridal)

Agents

Neuroleptics:

  • Benzamides, e.g., sulpiride (Dogmatil) and tiapride (Tiapridal).
  • Butyrphenones, e.g., pipamperone (Dipiperon).
  • Diphenylbutylpiperidines: penfluridol (Semap, out of trade).
  • Phenothiazines

Prokinetics:

  • Domperidone (Motilium)
  • Metoclopramide (Paspertin)
  • Alizapride (D)

Other:

  • Indirect dopamine antagonist: naltrexone.
  • Indirect dopamine antagonist by depletion of salivary vesicles: Tetrabenazine (Xenazine)