Dopamine in schizophrenia: a review and reconceptualization

Article Abstract:

Dopamine is an important chemical messenger in the brain. For many years, schizophrenia was thought to be caused by abnormally high dopamine activity (hyperdopaminergia). Early studies had indicated that neuroleptic drugs, which decrease dopamine activity, alleviated schizophrenic symptoms, and that the more the drug decreased dopamine activity, the more effective it was against the symptoms. Conversely, drugs that increased dopamine activity seemed to exacerbate the symptoms. More recent studies have indicated the relationship between dopamine and schizophrenia is more complex. Many schizophrenics do not respond to treatment with neuroleptic drugs, and drugs that increase dopamine activity rarely, if ever, induce schizophrenic symptoms in nonschizophrenics. The literature on the relationship between schizophrenia and dopamine is reviewed. Postmortem studies have shown that dopamine concentrations in schizophrenic brains are different from those seen in normal brains. However, the differences involve both areas of higher than normal and of lower than normal dopamine concentrations in the schizophrenic brains when compared with normal brains. Studies examining the actions of neuroleptics have shown that there are many types of dopamine receptors in the brain and that neuroleptics do not have an affinity for all types of receptors. The neuroleptic clozapine is often effective in treating patients who do not respond to other neuroleptics. Clozapine binds weakly to dopamine receptors relative to other neuroleptics, but it seems to have an affinity for certain types of dopamine receptors. These findings indicate that abnormal dopamine activity involving certain types of dopamine receptors is characteristic of the pathophysiology of schizophrenia, rather than an across-the-board abnormality in dopamine activity. Other studies have indicated that dopamine abnormalities in schizophrenics are localized in certain areas of the brain. The results from these studies taken together indicate that areas of both abnormally high dopamine activity and abnormally low dopamine activity in the brain are associated with schizophrenia, rather than a general hyperdopaminergia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Causes of, Physiological aspects, Mental illness, Mental disorders, Dopamine, Schizophrenia

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Clinical effects of clozapine on autistic disorder

Article Abstract:

Clozapine was effective in reducing symptoms of hyperactivity, fidgetiness and aggressiveness in autistic children who had minimal response to haloperidol treatment. Clozapine was administered at progressively increasing doses to two boys and one girl diagnosed with autistic disorder. Clinical effects of the neuroleptic were evaluated with the 28 items of the Children's Psychiatric Rating Scale and the Self-Injurious Behavior Questionnaire. After three months of clozapine treatment, all three patients had markedly decreased scores for both rating scales.

Usage, Drug therapy, Autism, Letter to the Editor, Antipsychotic drugs, Antipsychotic agents

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