Antipsychotics in the early stage of development.
OBJECTIVE
In this article, we will summarize some of the most recent pharmacological approaches by briefly reviewing the latest research results related to different neurotransmitter receptor systems but also alternative approaches that do not affect central nervous system receptors directly.


RESULTS
Although the field still struggles with the lack of major breakthroughs, some novel pharmacological leads have provided encouraging findings in proof of concept or early phase II clinical trials. Although some of these approaches are based on the modified dopamine/glutamate hypothesis of schizophrenia, others appear to have been driven by more serendipitous observations. Apart from this, more traditional routes such as compounds targeting D2/HT2 receptors are also still being pursued. Attempts to advance treatment response of negative symptoms and cognitive impairment, two areas of considerable unmet need have been an overriding theme in many studies.


CONCLUSIONS
Clinical psychopharmacologists increasingly realize that it is highly unlikely that we have a magic bullet to treat adequately all aspects of this complex disorder in the foreseeable future. Rational polypharmacy may be the trend for the next decade.
Department of Biological Psychiatry, Medical University Innsbruck, Innsbruck, Tyrol, Austria. falko.biedermann@uki.at
Falko
F
Biedermann
W Wolfgang
WW
Fleischhacker
D014150:Antipsychotic Agents / Q000627:therapeutic use*; D004298:Dopamine / Q000378:metabolism; D018698:Glutamic Acid / Q000378:metabolism; D006801:Humans; D007649:Ketamine / Q000008:administration & dosage / Q000494:pharmacology; D010622:Phencyclidine / Q000008:administration & dosage / Q000494:pharmacology; D011950:Receptors, Cholinergic / Q000502:physiology; D011976:Receptors, Muscarinic / Q000502:physiology; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors; D011978:Receptors, Nicotinic / Q000502:physiology; D011985:Receptors, Serotonin / Q000502:physiology; D012559:Schizophrenia / Q000188:drug therapy* / Q000378:metabolism; D012701:Serotonin / Q000502:physiology; D012720:Severity of Illness Index; D009435:Synaptic Transmission / Q000502:physiology
D014150:Antipsychotic Agents; D011950:Receptors, Cholinergic; D011976:Receptors, Muscarinic; D016194:Receptors, N-Methyl-D-Aspartate; D011978:Receptors, Nicotinic; D011985:Receptors, Serotonin; D012701:Serotonin; D018698:Glutamic Acid; D007649:Ketamine; D010622:Phencyclidine; D004298:Dopamine