2009 issue 3-4

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Volume 25, issue 3-4

Review article

NMDA receptor insufficiency in pathogenesis of schizophrenia

Marek Krzystanek1, Artur Pałasz2, Ewa Krzystanek3, Irena Krupka-Matuszczyk1
1. Katedra i Klinika Psychiatrii i Psychoterapii Śląskiego Uniwersytetu Medycznego w Katowicach
2. Katedra Morfologii Zakładu Histologii Śląskiego Uniwersytetu Medycznego w Katowicach
3. Katedra i Klinika Neurologii Śląskiego Uniwersytetu Medycznego w Katowicach
Farmakoterapia w Psychiatrii i Neurologii, 2009, 3-4, 179–190
Keywords: NMDA receptor, schizophrenia, neuroleptics

Abstract

In last years, many experimental and clinical studies helped to create the hypothesis of disturbed glutamatergic transmission in schizophrenia. The hypothesis is based on clinical finding that agonists of NMDA receptors may produce schizophrenia-like symptoms.
Contemporary data confirm that hypofunction of NMDA receptors plays a significant role in pathogenesis of schizophrenia. It seems that the systems: glutamatergic, dopaminergic and serotoninergic are functionally connected in schizophrenia. Classical and atypical neuroleptics may modulate activity of NMDA receptors. The known agonists of NMDA receptors and glycine re-uptake inhibitors seem to be more effective in the treatment of negative than positive schizophrenia symptoms. Their influence on cognitive dysfunctions is also possible. Results of clinical studies suggest that drugs enhancing NMDA receptor activity are more effective in combination with classical or atypical neuroleptic than in monotherapy of schizophrenia.
More clinical trials are necessary to establish the clinical position of drugs producing activation of NMDA receptor.

Address for correspondence:
Marek Krzystanek
Katedra i Klinika Psychiatrii i Psychoterapii
Śląski Uniwersytet Medyczny
ul. Ziołowa 45/47, 40-635 Katowice
tel/fax: 032 2059260
e-mail: krzystanekmarek@gmail.com