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This entry refers to a group of three second-generation (atypical) antipsychotic medications—aripiprazole, quetiapine, and risperidone—that are frequently grouped together as 'usual care' in clinical trials, such as the Northwell Health-sponsored study (NCT01844700) evaluating weight gain in pediatric patients. These small-molecule drugs are characterized by their modulation of dopamine and serotonin receptors. Aripiprazole (Abilify) is a partial agonist at dopamine D2 and serotonin 5-HT1A receptors and an antagonist at 5-HT2A. Quetiapine (Seroquel) acts as an antagonist at dopamine D1/D2, serotonin 5-HT2A, histamine H1, and alpha-1 adrenergic receptors. Risperidone (Risperdal) is a potent antagonist at dopamine D2 and serotonin 5-HT2A receptors. All three agents are FDA-approved for the treatment of schizophrenia, bipolar I disorder, and irritability associated with autism spectrum disorder, and they are being investigated for use in severe mood dysregulation.
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