[Pathophysiology of negative symptoms of schizophrenia and therapy with atypical neuroleptics]
Karavias, Georgio A.
Cyprus Medical Association
Bipolar Disorder Schizophrenia Dopamine Antagoniststherapeutic use Psychotic Disordersdrug therapy
Cyprus Medical Journal, v. 16, n. 1-2, 1998 [pg.29-31]
According to a ""bipolar"" hypothesis of dopaminergic activity in schizophrenia, positive symptoms are related to dopamine hyperactivity at the limbic brain areas, whereas negative symptoms are caused by dopamine hypofunction in the frontal cortex and prefrontal area. Drugs of choice to treat the negative symptoms are 5HT2/D2 atypical neuroleptics, which do not cause EPS at therapeutic doses, and which exhibit two modes of action (at the limbic system and at the frontal cortex), due to their potent 5HT2 blocking effect and their weak D2 blocking action. It is believed that selective serotonin blockage plays a role in improving the negative symptoms as well as reducing the potential for EPS. Atypical neuroleptics such as clozapine, sertindole, and risperidone, apart from their beneficial effect on secondary negative symptoms, may have a therapeutic effect on the negative of the deficit state, which constitutes the core symptoms of schizophrenia.