Editorials

Schizophrenia: a genetic disorder of the synapse?

BMJ 2005; 330 doi: http://dx.doi.org/10.1136/bmj.330.7484.158 (Published 20 January 2005) Cite this as: BMJ 2005;330:158
  1. Michael J Owen, professor of psychological medicine ([email protected]),
  2. Michael C O'Donovan, professor of psychiatric genetics,
  3. Paul J Harrison, professor of psychiatry
  1. Department of Psychological Medicine, School of Medicine, Cardiff University, Cardiff CF14 4XN
  2. Department of Psychological Medicine, School of Medicine, Cardiff University, Cardiff CF14 4XN
  3. University Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX

    Glutamatergic synapses might be the site of primary abnormalities

    Understanding the cause and pathogenesis of schizophrenia remains one of the great challenges in psychiatry. Progress has been slow, but one of the few certainties is that individual differences in liability are predominantly genetic.1 This information has, however, not been useful neurobiologically because the genes themselves had not been identified. This situation is beginning to change, allowing a reappraisal of existing hypotheses of pathogenesis.

    Until recently the two leading hypotheses concerned dopamine and neurodevelopment. The classic dopamine hypothesis, which attributed schizophrenia to a hyperdopaminergic state, arose from the ability of dopaminergic drugs to induce a psychosis, and the realisation that the potency of antipsychotic drugs is proportional to their ability to block dopamine receptors.2 Refinements of the hypothesis indicate a more complex picture—increased dopaminergic transmission in the basal ganglia may underlie acute psychosis,3 but a prefrontal cortical …

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