New approaches to the management of schizophrenia: focus on aberrant hippocampal drive of dopamine pathways

Stephanie M Perez, Daniel J LodgeDepartment of Pharmacology and Center for Biomedical Neuroscience, University of Texas Health Science Center, San Antonio, TX, USAAbstract: Schizophrenia is a disease affecting up to 1% of the population. Current therapies are based on the efficacy of chlorpromazine...

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Bibliographic Details
Main Authors: Perez SM, Lodge DJ
Format: Article
Language:English
Published: Dove Medical Press 2014-07-01
Series:Drug Design, Development and Therapy
Online Access:http://www.dovepress.com/new-approaches-to-the-management-of-schizophrenia-focus-on-aberrant-hi-peer-reviewed-article-DDDT
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Summary:Stephanie M Perez, Daniel J LodgeDepartment of Pharmacology and Center for Biomedical Neuroscience, University of Texas Health Science Center, San Antonio, TX, USAAbstract: Schizophrenia is a disease affecting up to 1% of the population. Current therapies are based on the efficacy of chlorpromazine, discovered over 50 years ago. These drugs block dopamine D2-like receptors and are effective at primarily treating positive symptoms in a subset of patients. Unfortunately, current therapies are far from adequate, and novel treatments require a better understanding of disease pathophysiology. Here we review the dopamine, gamma-aminobutyric acid (GABA), and glutamate hypotheses of schizophrenia and describe a pathway whereby a loss of inhibitory signaling in ventral regions of the hippocampus actually drives a dopamine hyperfunction. Moreover, we discuss novel therapeutic approaches aimed at attenuating ventral hippocampal activity in a preclinical model of schizophrenia, namely the MAM GD17 rat. Specifically, pharmacological (allosteric modulators of the α5 GABAA receptor), neurosurgical (deep brain stimulation), and cell-based (GABAergic precursor transplants) therapies are discussed. By better understanding the underlying circuit level dysfunctions in schizophrenia, novel treatments can be advanced that may provide better efficacy and a superior side effect profile to conventional antipsychotic medications.Keywords: dopamine, GABA, glutamate, schizophrenia, hippocampus, MAM rat
ISSN:1177-8881