J Lyne1, B D Kelly, W T O'Connor. 1. Department of Psychiatry and Mental Health Research, St Vincent's University Hospital/University College Dublin, Ireland.
Abstract
BACKGROUND: The last few decades have seen significant advances in our understanding of the neurochemical basis of schizophrenia. AIMS: To describe the neurotransmitter systems and nerve circuits implicated in schizophrenia; to compare the neuropharmacology of typical and atypical anti-psychotic agents; and to describe recent developments in the pharmacological treatment of schizophrenia. METHODS: Relevant pharmacological, neurophysiological and psychiatric literature was examined and reviewed. RESULTS: Schizophrenia is associated with abnormalities of multiple neurotransmitter systems, including dopamine, serotonin, gamma-aminobutyric acid and glutamate. Typical and atypical antipsychotic agents differ in their receptor-binding affinities, which are related to their differing side-effect profiles. Novel therapeutic strategies include normalisation of synaptic dopamine or serotonin levels, serotonin receptor antagonism and modulation of cerebral protein synthesis. CONCLUSIONS: The ideal treatment for schizophrenia may not be a single pharmacological agent but several agents that match the different expressions of the illness, in combination with psycho-social interventions.
BACKGROUND: The last few decades have seen significant advances in our understanding of the neurochemical basis of schizophrenia. AIMS: To describe the neurotransmitter systems and nerve circuits implicated in schizophrenia; to compare the neuropharmacology of typical and atypical anti-psychotic agents; and to describe recent developments in the pharmacological treatment of schizophrenia. METHODS: Relevant pharmacological, neurophysiological and psychiatric literature was examined and reviewed. RESULTS:Schizophrenia is associated with abnormalities of multiple neurotransmitter systems, including dopamine, serotonin, gamma-aminobutyric acid and glutamate. Typical and atypical antipsychotic agents differ in their receptor-binding affinities, which are related to their differing side-effect profiles. Novel therapeutic strategies include normalisation of synaptic dopamine or serotonin levels, serotonin receptor antagonism and modulation of cerebral protein synthesis. CONCLUSIONS: The ideal treatment for schizophrenia may not be a single pharmacological agent but several agents that match the different expressions of the illness, in combination with psycho-social interventions.
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