A. Rossi, A. Tomassini, P. Stratta - Vol. 10, December 2004, Issue 4
Testo Immagini Bibliografia Summary Indice
Cognitività e Dopamina: aspetti
clinici nella schizofrenia
Cognition and dopamine: clinical aspects in schizophrenia
The revision of the classical dopamine hypothesis of schizophrenia states that a deficit in dopaminergic activity may explain the presence of negative and cognitive symptoms, whereas an excess in dopaminergic transmission would be associated with the appearance of positive symptoms. In particular, during the last decade, cognitive deficit was the subject of much attention of clinical and basic investigators, as it correlates with the functional outcome of schizophrenic disorder.
The use of atypical antipsychotic drugs lend in part support to such hypothesis, showing less overall extrapyramidal side effects and a stronger action against negative and cognitive symptoms. It is not clear whether such action is primary or mediated by decreased iatrogenic side effects. Serotonin 5-HT2 receptor blockade by some atypical antipsychotics could explain their action on negative and cognitive symptoms.
A recently introduced atypical antipsychotic drug, aripiprazole, is endowed with partial dopaminergic agonist activity; its activity introduces the concept of dopaminergic system stabilization as potentially able to explain the "concomitant" activity on both ‘hyperdopaminergic’ and ‘hypodopaminergic’ symptoms.
The use of antipsychotic drugs with differential action on the dopaminergic system may contribute to the clarification of the role of dopamine in symptom clusters associated with schizophrenia.