title: Anticholinergic Activity and Schizophrenia.
abstract: In this article, we review the downregulation of acetylcholinergic activity in schizophrenia and discuss the similarity and difference between Alzheimer's disease (AD) and schizophrenia in terms of acetylcholine (ACh) and anticholinergic activity (AA); then, we propose the use of cognition-enhancing therapy for schizophrenia. As ACh regulates an inflammatory system, when the cholinergic system is downregulated to a critical level, the inflammatory system is activated. We consider the possibility that AA appears endogenously in AD and accelerates AD pathology. This hypothesis can also be applied to schizophrenia. In fact, even before the onset of the disorder, in the prodromal phase of schizophrenia, cognitive dysfunction exists, and antibodies against astrocyte muscarinic-1 and muscarinic-2 receptors are present in the serum of patients with the paranoid type of schizophrenia. Then we noted that the prodromal phase in schizophrenia might correspond to the mild stage in AD and the acute phase to moderate stage concerning AA. We also think that we should enhance cognition in schizophrenia even in the prodromal phase because as mentioned above, downregulation of ACh is prominent in schizophrenia even in the prodromal phase.
authors.affiliation: Department of Psychiatry, Showa University East Hospital, Tokyo, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Tani
authors.forename: Norihisa
authors.initials: N
authors.lastname: Akashi
authors.forename: Koji
authors.initials: K
authors.lastname: Hori
authors.forename: Kimiko
authors.initials: K
authors.lastname: Konishi
authors.forename: Yuka
authors.initials: Y
authors.lastname: Kitajima
authors.forename: Hiroi
authors.initials: H
authors.lastname: Tomioka
authors.forename: Atsuko
authors.initials: A
authors.lastname: Inamoto
authors.forename: Akihito
authors.initials: A
authors.lastname: Hirata
authors.forename: Akisa
authors.initials: A
authors.lastname: Tomita
authors.forename: Taishi
authors.initials: T
authors.lastname: Koganemaru
authors.forename: Akari
authors.initials: A
authors.lastname: Takahashi
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Hachisu
mesh_terms: D000818:Animals; D018680:Cholinergic Antagonists / Q000378:metabolism* / Q000627:therapeutic use*; D006801:Humans; D012559:Schizophrenia / Q000188:drug therapy* / Q000378:metabolism*
chemical_list: D018680:Cholinergic Antagonists