Psychopharmacology of schizophrenia: The Future Looks Bleak.
BACKGROUND
More than half a century after the introduction of effective pharmacotherapy for the illness, in most patients schizophrenia remains a chronic, relapsing condition with poor long-term outcomes.


METHODS
We examine the pharmacological treatment of schizophrenia from different perspectives to understand why there have not been significant advances, and to consider what the future might hold in store.


RESULTS
We argue that the treatment of schizophrenia addresses the phenotype and not the cause; that the causes may not be treatable even if identifiable; that secondary prevention approaches involving treating the phenotype before full-fledged illness develops have, so far, not yielded promising results; and that shifting the focus of treatment from dopamine to other neurotransmitter systems is merely a tertiary prevention approach which will not reverse the extensive structural and functional pathology of schizophrenia.


CONCLUSIONS
We believe that, given the current state of our knowledge of the illness, the future of the pharmacotherapy of schizophrenia looks bleak.
Professor and Head, Department of Psychopharmacology, National Institute of Mental Health and Neurosciences, Bangalore-560 029, India.
Chittaranjan
C
Andrade
Rajiv
R
Radhakrishnan
Praveen P
PP
Fernandes