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Hypofunctional Dopamine Uptake and Antipsychotic Treatment-Resistant Schizophrenia

Antipsychotic treatment resistance in schizophrenia remains a major issue in psychiatry. Nearly 30% of patients with schizophrenia do not respond to antipsychotic treatment, yet the underlying neurobiological causes are unknown. All effective antipsychotic medications are thought to achieve their ef...

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Autores principales: Amato, Davide, Kruyer, Anna, Samaha, Anne-Noël, Heinz, Andreas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6557273/
https://www.ncbi.nlm.nih.gov/pubmed/31214054
http://dx.doi.org/10.3389/fpsyt.2019.00314
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author Amato, Davide
Kruyer, Anna
Samaha, Anne-Noël
Heinz, Andreas
author_facet Amato, Davide
Kruyer, Anna
Samaha, Anne-Noël
Heinz, Andreas
author_sort Amato, Davide
collection PubMed
description Antipsychotic treatment resistance in schizophrenia remains a major issue in psychiatry. Nearly 30% of patients with schizophrenia do not respond to antipsychotic treatment, yet the underlying neurobiological causes are unknown. All effective antipsychotic medications are thought to achieve their efficacy by targeting the dopaminergic system. Here we review early literature describing the fundamental mechanisms of antipsychotic drug efficacy, highlighting mechanistic concepts that have persisted over time. We then reconsider the original framework for understanding antipsychotic efficacy in light of recent advances in our scientific understanding of the dopaminergic effects of antipsychotics. Based on these new insights, we describe a role for the dopamine transporter in the genesis of both antipsychotic therapeutic response and primary resistance. We believe that this discussion will help delineate the dopaminergic nature of antipsychotic treatment-resistant schizophrenia.
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spelling pubmed-65572732019-06-18 Hypofunctional Dopamine Uptake and Antipsychotic Treatment-Resistant Schizophrenia Amato, Davide Kruyer, Anna Samaha, Anne-Noël Heinz, Andreas Front Psychiatry Psychiatry Antipsychotic treatment resistance in schizophrenia remains a major issue in psychiatry. Nearly 30% of patients with schizophrenia do not respond to antipsychotic treatment, yet the underlying neurobiological causes are unknown. All effective antipsychotic medications are thought to achieve their efficacy by targeting the dopaminergic system. Here we review early literature describing the fundamental mechanisms of antipsychotic drug efficacy, highlighting mechanistic concepts that have persisted over time. We then reconsider the original framework for understanding antipsychotic efficacy in light of recent advances in our scientific understanding of the dopaminergic effects of antipsychotics. Based on these new insights, we describe a role for the dopamine transporter in the genesis of both antipsychotic therapeutic response and primary resistance. We believe that this discussion will help delineate the dopaminergic nature of antipsychotic treatment-resistant schizophrenia. Frontiers Media S.A. 2019-05-28 /pmc/articles/PMC6557273/ /pubmed/31214054 http://dx.doi.org/10.3389/fpsyt.2019.00314 Text en Copyright © 2019 Amato, Kruyer, Samaha and Heinz http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Amato, Davide
Kruyer, Anna
Samaha, Anne-Noël
Heinz, Andreas
Hypofunctional Dopamine Uptake and Antipsychotic Treatment-Resistant Schizophrenia
title Hypofunctional Dopamine Uptake and Antipsychotic Treatment-Resistant Schizophrenia
title_full Hypofunctional Dopamine Uptake and Antipsychotic Treatment-Resistant Schizophrenia
title_fullStr Hypofunctional Dopamine Uptake and Antipsychotic Treatment-Resistant Schizophrenia
title_full_unstemmed Hypofunctional Dopamine Uptake and Antipsychotic Treatment-Resistant Schizophrenia
title_short Hypofunctional Dopamine Uptake and Antipsychotic Treatment-Resistant Schizophrenia
title_sort hypofunctional dopamine uptake and antipsychotic treatment-resistant schizophrenia
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6557273/
https://www.ncbi.nlm.nih.gov/pubmed/31214054
http://dx.doi.org/10.3389/fpsyt.2019.00314
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