Paliperidone / Risperidone
Strong D2 blockade, minimal D1, 5-HT2A antagonism
May cause cognitive dulling at higher doses
Can cause amotivation / boredom / apathy
Moderate risk (indirect dopamine suppression
Aripiprazole
D2 partial agonist, 5-HT1A agonist
Neutral to mildly pro-cognitive
Less likely to cause apathy (can feel more âenergizingâ)
Low risk â sometimes helpful in ADHD comorbidity
Lurasidone
D2 blockade, strong 5-HT7 antagonism (pro-cognitive), 5-HT1A agonist
Best evidence for cognitive benefit in schizophrenia
Less sedation, relatively motivation-friendly
Clozapine
Weak D2, strong 5-HT2A, muscarinic, histamine
Mixed: can impair memory (anticholinergic), but improves negative symptoms
Improves motivation in resistant cases
Moderate risk (due to sedation, anticholinergic effects)
Answered2025-08-17 19:46:03
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