Dopamine and norepinephrine activity in schizophrenia. An integrative perspective

The dopamine (DA) hypothesis of schizophrenia stated that increased DA activity is the primary cause of schizophrenia. Recently, even though increased DA activity is in fact involved in psychotic symptoms and antipsychotic drug response, it has become clear that decreased DA activity is present in remitted and chronic states and may relate to deficit symptoms and cortical lesions. In addition, the norepinephrine (NE) system seems to be involved in symptomatology, antipsychotic drug response, course, and outcome in schizophrenia. This review supports the hypothesis that a disturbance in DA and NE activity regulates schizophrenic behavior. A plethora of DA- and NE-related findings in schizophrenic patients are reviewed in relationship to each other according to basic science data and to presently entertained hypotheses, with emphasis on a neural developmental disturbance interacting with a genetic predisposition shaped by environmental factors.