[Perspectives on the therapy of neuropsychiatric diseases with adenosinergic substances]

The function of the neuromodulator, adenosine, has been thoroughly examined during the last two decades. Adenosine inhibits the release of several neurotransmitters and endogenous adenosine is supposed to have sedative and anticonvulsive properties. Lately, it has been discussed whether neuropsychiatric disorders could be treated with adenosynergic drugs. In patients with anxiety disorder a first clinical trial with the reuptake inhibitor dipyridamole was not successful. Disorders of the basal ganglia and schizophrenia might be positively influenced by newly developed A2-receptor ligands. A1-receptor agonists might prove to be neuroprotective; they also could be of importance in the treatment of epilepsy. Selective A1-receptor antagonists might be used in the treatment of depressive disorders and of neurodegenerative disorders such as Alzheimer's disease. The adenosine receptor antagonist, caffeine, is widely used in the treatment of migraine; more selective antagonists would provide a more powerful treatment.