S Rehan Ahmad
1* 
, Md Zeyaullah
2* , Abdullah M. AlShahrani
2, Mohammad Suhail Khan
3, Adam Dawria
3, Ali Mohieldin
3, Haroon Ali
3, Abdelrhman AG Altijani
3, Mohammad Shane Alam
4, Munzila Mehdi
5, Sabika Akram
5, Ejaz Rizvi Hussain
5, Mohammad Amjad Kamal
6,7,81 Hiralal Mazumdar Memorial College for Women, West Bengal State University, Kolkata , West Bengal , 700035, India
2 Department of Basic Medical Science, College of Applied Medical Sciences, Khamis Mushayt Campus, King Khalid University, Abha 62561, Saudi Arabia
3 Department of Public Health, College of Applied Medical Sciences, Khamis Mushait Campus, King Khalid University, Abha 62561, Saudi Arabia
4 Department of Medical Laboratory Technology, College of Applied Medical Sciences, Jazan University, Kingdom of Saudi Arabia, Jizan 45142, Saudi Arabia
5 Department of Botany, Aligarh Muslim University, Uttar Pradesh, Aligarh 202002, India
6 Joint Laboratory of Artificial Intelligence in Healthcare, Institutes for Systems Genetics and West China School of Nursing, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu 610000, Sichuan Province, China
7 Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh
8 Enzymoics, 7 Peterlee place, Novel Global Community Educational Foundation, Hebersham, NSW 2770, Australia
Abstract
Schizophrenia is a devastating chronic mental health illness which includes a complex set of symptoms like hallucination, illusion and delusion, and to manage, lifelong antipsychotic medications are needed. Schizophrenia affects 1% of the population worldwide, and to date, two different classes of antipsychotics, i.e., typical and atypical antipsychotics, are available in the market, and there is an urgent need for promising antipsychotic drugs. In this review, we focus on recently approved antipsychotics and then focus on different antipsychotic drugs under clinical trials. In this review, we first focus on lumateperone in detail, which was approved in December 2019 by the Food and Drug Administration (FDA) and simultaneously modulates serotonin, glutamate and dopamine neurotransmitters and is used at doses of 10.5-, 21- and 42 mg, which show mild adverse effects like constipation, sedation, somnolence and fatigue. This review also focuses on a few more emerging antipsychotics like brexpiprazole, brilaroxazine, roluperidone, F17464, pimavanserin (ACP-103), xanomeline, BI 409306, BI 425809 and MK-8189 which are under different phase of clinical trials and might get approved soon. Brexpiprazole and brilaroxazine act on dopamine receptors, whereas xanomeline, pimavanserin and roluperidone do not act on D2 receptors and manage the symptoms. All the antipsychotic drugs covered did not show any other severe adverse effects except gastrointestinal issues and cardiometabolic risk factors. However, still rigorous clinical trials and modifications are needed to manage adverse effects, and we can expect a few antipsychotics to be on the market soon.