Aripiprazole and brexpiprazole belong to a class of atypical antipsychotics known as dopamine D2 receptor partial agonists. This unique mechanism allows them to act as functional antagonists in states of high dopamine activity (e.g., psychosis) and as functional agonists in states of low dopamine activity, thereby stabilizing dopamine neurotransmission. Strong D2 receptor antagonism (A) is characteristic of typical antipsychotics and some atypicals like risperidone. Selective serotonin reuptake inhibition (C) is the mechanism of SSRIs. Alpha-1 adrenergic receptor blockade (D) is a common side effect of many antipsychotics (e.g., orthostatic hypotension) but not their primary therapeutic mechanism.
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