Anatomic and molecular principles of psychopharmacology - A primer for psychiatrists

Modulation of neuronal activity by neurotransmitters is a fundamental mecha nism of brain function. Perturbations of neurotransmission in disease state s can be targeted therapeutically through the administration of psychotropi c drugs. This article reviews three mechanisms that explain the therapeutic and adverse effects of psychotropic agents. First, the location and projec tion of neurons determines their behavioral affiliation. Second, neurotrans mitter receptors lead to changes in the electrical properties (i.e., membra ne potential) or the biochemical properties (i.e., protein function) of neu rons. Third, intracellular signaling pathways lead to immediate or delayed, longer-term effects on neuronal function. These three principles and their clinical implications are reviewed for the glutamatergic, GABAergic, choli nergic, serotonergic, noradrenergic, and dopaminergic systems.