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Perspectives on the role of serotonergic mechanisms in the pharmacology of schizophrenia

Section of Clinical Neuropharmacology, Department of Psychological Medicine, Institute of Psychiatry, DeCrespigny Park, Denmark Hill, London SE5 8AF, UK

R.W. Kerwin

Section of Clinical Neuropharmacology, Department of Psychological Medicine, Institute of Psychiatry, DeCrespigny Park, Denmark Hill, London SE5 8AF, UK

In recent years, a number of research findings has renewed interest in the possible role of serotonin (5-HT) in the pharmacology of schizophrenia. Atypical antipsychotics that potently block 5-HT receptors have been shown to be at least as effective as classical antipsychotics as well as producing fewer extrapyramidal side-effects. In addition, molecular biological studies have suggested that allelic variations of 5-HT receptor genes may affect both susceptibility to schizophrenia and clinical response to atypical antipsychotics. Building on these findings, this article proposes that 5-HT receptors are critical sites of antipsychotic action, and examines the implications of this to the treatment and pathophysiology of schizophrenia. Possible pharmacological mechanisms underlying the clinical efficacy of 5-HT blocking antipsychotics are discussed, and the potential of functional neuroimaging techniques to further elucidate these mechanisms is emphasized.

Key Words: 5-HT2 receptors • extrapyramidal side-effects • atypical antipsychotics • clozapine • risperidone • serotonin

Journal of Psychopharmacology, Vol. 11, No. 1, 3-12 (1997)
DOI: 10.1177/026988119701100102


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