Glutamate antagonists in neurology

Glutamate is the major excitatory neurotransmitter of the central nervous s ystem. Besides its importance in many physiological processes, increased gl utamate release and subsequent excessive stimulation of the various glutama te receptors are thought to play critical roles in the pathophysiological m echanisms underlying many neurologic diseases. Experimental data suggest th at blockade of glutamate receptors or inhibition of glutamate release has p ositive effects in many disease models. Glutamate antagonists are already i n clinical use for the treatment of Parkinson's disease, epilepsy, spastici ty, and neuropathic pain. Overall, glutamate antagonists have not been foun d clinically effective for neuroprotective treatment of cerebral ischemia o r chronic neurodegenerative diseases, with one exception. Side effects of g lutamate antagonists can be mainly attributed to central mechanisms and inc lude psychosis, agitation, and disorientation. lt is to be hoped that furth er development of new glutamate antagonists that block disease-relevant sub types of glutamate receptors will lead to more effective drugs with fewer s ide effects.