ANTIPSYCHOTIC DRUG MECHANISMS AND NEUROTRANSMITTER SYSTEMS IN SCHIZOPHRENIA

The dopamine hypothesis of schizophrenia has been central to the under standing of the mechanism of action of the antipsychotic drugs. Certai nly the close correlation between drug dosage and affinity for D-2 dop amine receptors indicates the importance of these receptors in the ant ipsychotic response, although D, antagonism can also induce acute extr apyramidal side effects. The antipsychotic drugs also act at other neu rotransmitter receptors, and these actions contribute to the unwanted side effects of treatment. The use of selective D-2 antagonists can di minish such effects, although effects at other receptors are reported to be of value in minimizing extrapyramidal syndromes as well as in en hancing response either directly or by diminishing negative symptoms. The present understanding of these receptor mechanisms is reviewed.