The dopamine D3 receptor and schizophrenia: pharmacological, anatomical and genetic approaches

Antipsychotic drug therapy mainly rests on the use of antagonists of dopamine D2-like (D2, D3 and D4) receptors, for which all clinically active compounds have high affinity. The D3 receptor has a restricted expression in brain limbic areas, associated with cognitive functions and motivated behavior. D3 selective agonists and antagonists reveal an inhibitory role on motor behaviors for the D3 receptor, opposite to that of the D2 receptor. An opposing role for D2 and D3 receptors is also suggested by the contrasted effects of D2/D3 antagonists on neurotensin expression in discrete subdivisions of nucleus accumbens, where D2 and D3 receptors are selectively expressed. Tolerance to the motor but not to the therapeutic effects of neuroleptics is observed after repeated administration, which upregulates the D2, but not the D3 receptor in animals. In genetic association studies, an excess of homozygosity for both alleles of the BalI polymorphism at the D3 receptor gene was found in schizophrenic patients, suggesting that this gene may have subtle influence on the liability to develop schizophrenia. These results suggest the D3 receptor as an important target for antipsychotic drug action, and D3 receptor selective antagonists as promising therapeutic agents.