Sigma-1 antagonist

Name: Sigma-1 antagonist
Creator: Jason Cafer, MD

Sigma-1 receptor antagonist

Not a neurotoxic mechanism, but could theoretically interfere with neuroprotective mechanisms σ1 agonists
Could interfere with the σ1-based antidepressant effect of Auvelity σ1 antagonists ranked by ~binding affinity
Haloperidol

Drugs with this mechanism (7)

Fluphenazine — High-potency phenothiazine, available as a long-acting depot.
Fluphenazine decanoate LAI — High-potency first-generation antipsychotic depot; inexpensive but extrapyramidal-effect heavy.
Haloperidol — Prototypical high-potency typical antipsychotic; potent D2 blocker, high EPS risk.
Haloperidol decanoate LAI — First-generation D2-antagonist depot for schizophrenia maintenance; EPS burden is high.
Haloperidol injection — Parenteral high-potency D2 antipsychotic for acute agitation; IV use magnifies QT concern.
Perphenazine — Mid-potency typical; performed comparably to atypicals in CATIE.
Sertraline — Broadly indicated SSRI with few CYP interactions; GI effects are prominent early.