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: Antiparkinsonian

or Sedative-hypnotic

or Selective 5HT2A inverse agonist (with weaker 5HT2C inverse agonism)

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None (10) · (none, never marketed) (1) · Akineton (1) · Apokyn (1) · Artane (1) · Azilect (1) · Cogentin (1) · Comtan (1) · Dalmane (1) · Doral (1) · Doriden (1) · Dostinex (1) · Eldepryl (1) · Halcion (1) · Hetlioz (1) · Imovane (1) · Lunesta (1) · Mogadon (1) · Nembutal (1) · Neupro (1) · Nuplazid (1) · Ongentys (1) · Parlodel (1) · Placidyl (1) · ProSom (1) · Quaalude (1) · Restoril (1) · Rohypnol (1) · Rozerem (1) · Seconal (1) · Sinemet (1) · Sonata (1) · Symmetrel (1) · Tasmar (1) · THIP (1) · Versed (1) · Xadago (1) · Xyrem (1)

None (2) · Central and peripheral COMT inhibitor (1) · D1/D2/D3 receptor agonist (1) · D2 agonist; D1 partial agonist (1) · D2 receptor agonist (1) · Dopamine precursor (1) · Dopamine precursor + DOPA decarboxylase inhibitor (1) · Extremely potent GABAA positive allosteric modulator (1) · GABAA positive allosteric modulator (15) · GABAA positive allosteric modulator (non-benzodiazepine) (3) · GABAA positive allosteric modulator; very long half-life (1) · GABAA potentiator (1) · GABAA potentiator and direct activator (2) · GABAB agonist; GHB receptor agonist (1) · Irreversible selective MAO-B inhibitor (2) · MAO-B inhibitor; sodium channel blocker; glutamate release inhibitor (1) · Melatonin receptor agonist (2) · Muscarinic receptor antagonist (1) · Muscarinic receptor antagonist; dopamine reuptake inhibitor (1) · NMDA antagonist; dopamine releasing agent (1) · Non-selective dopamine receptor agonist (1) · Once-daily COMT inhibitor (1) · Peripheral COMT inhibitor (1) · Positive allosteric modulator of the GABA<sub>A</sub> receptor at the benzodiazepine binding site; increases frequency of Cl<sup>−</sup> channel opening, producing anxiolytic, sedative, hypnotic, anticonvulsant, and skeletal-muscle relaxant effects. (1) · Selective GABAA agonist (extrasynaptic delta subunit) (1) · Selective inverse agonist at 5HT2A receptors with weaker activity at 5HT2C. Has no significant dopamine D2 affinity, unique among approved antipsychotics. Inverse agonism (rather than antagonism) reduces constitutive 5HT2A receptor activity below baseline. (1) · Selective M1 muscarinic antagonist (1)

None (45) · Hallucinations and delusions associated with Parkinson's disease psychosis (PDP). Investigational for psychosis in other dementias and as augmentation for depression. (1) · No approved medical problem. Encountered as a designer/research benzodiazepine and, increasingly, as an adulterant in illicit opioid supplies. (1)

None (45) · 34 mg PO once daily (1) · No medical dose. Active recreational doses reported in the 0.5–1.5 mg range (similar potency to alprazolam). (1)

None (45) · 10 mg, 34 mg capsules/tablets (1) · Illicit tablets ("bars"), powders, blotter, occasionally solutions. No pharmaceutical product exists. (1)

None (45) · 34 mg/d (1) · N/A (never approved) (1)

None (45) · intranasal; rectal and IV reported. (1) · Oral (2) · sublingual (1)

None (45) · Benefit over weeks of dosing (1) · ~20–40 min PO; faster sublingual/intranasal. (1)

None (45) · 6–10 h subjective; full pharmacologic effect considerably longer. (1) · Daily dosing (1)

None (45) · Estimated ~12–17 h (some sources cite up to ~21 h); active metabolites prolong effect. (1) · ~57 hours (parent), ~200 h (active metabolite) (1)

None (45) · Not characterized; oral dosing once daily (1) · Not formally characterized in humans. (1)

None (45) · Avoid. Benzodiazepines are associated with neonatal sedation, floppy-infant syndrome, and withdrawal; teratogenic signal weak but non-zero. Designer benzo with no safety data, assume worst-case. (1) · Limited data; avoid (1)

None (46) · Rx. FDA black-box warning for increased mortality in elderly patients with dementia-related psychosis (class warning shared with all antipsychotics) (1)

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