Two months Old but I thought the following was worth a re-read:
From
Clinical Psychiatry News
Looking Past Dopamine for Schizophrenia
Anna Nidecker, Senior Writer
[Clinical Psychiatry News 26(9):11, 1998. © 1998 International Medical News
Group.]
TORONTO -- Schizophrenia treatment is nearing the end of the dopamine era, as
researchers look to
agents that target other systems in the brain, Dr. H. Christian Fibiger said at the annual
meeting of the Society
of Biological Psychiatry.
All currently prescribed antipsychotics, which primarily target dopamine circuits in the
brain, leave many
patients with untreated cognitive deficits and negative symptoms, said Dr. Fibiger, of
Eli Lilly & Co.,
Indianapolis.
Some of the atypical antipsychotics that also target other neurotransmitters, such as
risperidone and
olanzapine, have had some effect on cognition and negative symptoms, but they still
leave a lot of room for
improvement, he said. Studies have shown that only up to 20% of patients on these
medications are able to
work more than 75% of the time.
"I would be surprised if we get better results in future studies, and we have to do better
than that," Dr.
Fibiger said. He described some of the new targets under study that may provide an
alternative:
Serotonin Receptors. It's believed that the serotonergic activity of some of the atypical
antipsychotics are behind their effects on the cognitive and negative symptoms of
schizophrenia.
Glutamate Receptors. Drugs called ampakines augment the effects of glutamate, the
principal
excitatory neurotransmitter in the brain, by stimulating one of its receptors, the AMPA
receptor.
Ampakines increase cognitive function in rodents and memory in humans. They are
being tested
clinically for treating the cognitive deficits of schizophrenia.
Cholinergic Receptors. Still in the preclinical stages of research, agents that augment
the activity of
the muscarinic receptor may help with the cognitive symptoms of Alzheimer's disease.
They represent
a possible treatment for cognitive deficits in schizophrenia patients.
Neuropeptide Receptors. Drugs that affect various neuropeptides believed to be
involved in
neurotransmission may also fit into this picture. Antagonists to corticotropin-releasing
factor, and
agonists to cholecystokinin and neurotensin may help with some cognitive and negative
affect in
schizophrenia patients.
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