Neurochemical and neuroendocrine measures and prediction of outcome to neuroleptic therapy
The early discrimination between responders and non-responders would be of substantial clinical relevance in optimizing neuroleptic therapy. Identification of early predictors of outcome to neuroleptic treatment would be useful for avoiding unnecessary treatment of refractory patients (Harvey et al. 1991). Despite the numerous studies performed to find “markers” of neuroleptic response in acute psychotic patients getting “the right drug for the right patient” has remained an unsolved problem. Although the biological basis of schizophrenia is unknown so far, there is much evidence of an abnormal dopamine (DA) activity being an important factor in schizophrenia. In a recent study, Seeman et al. (1993) reported a sixfold elevation in the density of dopamine D4 receptors in schizophrenia. The dopamine hypothesis, primarily based on the fact that neuroleptics block dopamine receptors and that their ability to displace dopamine antagonists in vitro, correlates significantly with their clinical antipsychotic potencies (Seeman et al. 1976). Although recent advances in biochemical research suggest that several neurotransmitter systems are involved in the pathophysiology of schizophrenia, dysfunctions in the dopaminergic and noradrenergic system are a matter of great significance. This paper will review studies addressing neurochemical and neuroendocrine measures associated with drug response in schizophrenia (Table 1).
KeywordsSchizophrenic Patient Neuroleptic Treatment Bioi Psychiatry Dopamine Hypothesis Neuroleptic Therapy
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