THE ROLE OF SEROTONIN IN THE PATHOPHYSIOLOGY AND TREATMENT OF SCHIZOPHRENIA

The concept of ''balanced serotonergic/dopaminergic antagonists'' refl ects renewed interest in the role of serotonin (5-HT) in schizophrenia . Postmortem brain tissue analysis, cerebrospinal fluid studies, and p harmacological challenges suggest a deficit in 5-HT function in the co rtex of patients with schizophrenia. In contrast, however, 5-HT2 antag onism is claimed to have beneficial effects on both positive and negat ive symptoms of the illness. The authors attempt to resolve this parad ox with a model that takes into account the suggestion of a cortical s erotonergic hypofunction and a beneficial effect of 5-HT, antagonism v ia modulation of subcortical dopamine activity. Although involvement o f 5-HT in schizophrenia is supported by compelling evidence, more rese arch is needed to better define its role in pathophysiology and treatm ent of this illness.