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Dihydrexidine is a moderately selective, full agonist at the dopamine D1 receptor (DRD1) and dopamine D5 receptor (DRD5), with approximately 10-fold selectivity for these over the dopamine D2 receptor. It was the first dopamine D1 receptor agonist to demonstrate potent antiparkinsonian activity in primate models of Parkinson's disease. Unlike many dopaminergic agents, it shows no significant agonist activity at peripheral D2 receptors or adrenoceptors at doses that maximally stimulate central D1 sites. Its mechanism involves stimulating cyclic AMP synthesis via activation of dopamine D1-like receptors in the brain. Although early clinical trials for Parkinson’s disease were halted due to profound hypotension with intravenous administration, subsequent studies using lower subcutaneous doses showed improved safety profiles. The drug has also been investigated for cognitive enhancement and alleviation of working memory deficits in schizophrenia and schizotypal disorder, as well as studied in cocaine-related disorders[3][5][7].
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