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Schizophrenia: a review of neuropharmacology
J Lyne1, B D Kelly, W T O'Connor
1Department of Psychiatry and Mental Health Research, St Vincent's University Hospital/University College Dublin, Ireland.
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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