Glutamate Hypothesis of Schizophrenia - Current State of Schizophrenia Treatment

Current State of Schizophrenia Treatment

Schizophrenia that is unmanagable by lifestyle changes (like reducing stress or stopping drug habits) is now treated by medications known as antipsychotics (or neuroleptics) that typically reduce dopaminergic activity because too much activity has been most strongly linked to positive symptoms, specifically persecutory delusions. Dopaminergic drugs do not induce the characteristic auditory hallucinations of schizophrenia. The typical antipsychotics are known to have significant risks of side effects that can increase over time, and only show clinical effectiveness in reducing positive symptoms. Additionally, although newer atypical antipsychotics can have less affinity for dopamine receptors and still reduce positive symptoms, do not significantly reduce negative symptoms.

Recent studies using an animal model, have indicated that a 5-HT1A agonist and CB1 antagonist and CB2 agonist (cannabidiol) are effective as treating schizophrenia as atypical antipsychotics. Many atypicals hold 5HT1A agonist properties as well, but this phytocannabinoid is of specific interest due to its effect on glial cells within the basal ganglia, and the entorhinal cortex, where studies in rats have shown functional CB2 receptors expressed in neurons. Research into potential benefits is extremely difficult due to the highly restrictive drug laws throughout the world.

Very low dose psychedelics may also have promise in treating these deficits in schizophrenia, specifically alleviating negative symptoms. (Roth, B Meltzer, H) However, the validity of this study is of some concern.

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