Pharmacologic advances in the treatment of schizophrenia.

The treatment ofschizophrenia was reuolutionizedwith the introduction cfchlorpromaeine in 1952. The dfectiveness qfchlorpromazine in controlling psychotic symptoms lead to the dopamine hypothesis ofschizophrenia, which revolutionized our conceptualization ofthis illness. Si nce that time, numerous typical antipsychotic drugs have been developedfo r the treatment ofschizophrenia. However, the introductionofclozapine in 1990 began a new era in thepharmacologic management qfschizophrenia. Clozapine, an atypical antipsychotic drug, is dfective in controlling the positive symptoms ofschizophrenia in a large numberofotherwise treatment-resistant patients, and also improves the negative symptoms qf the illness in marry patients. Clozapine is classified as an atypical antipsychotic drug because it has little potential for causing extrapy ramidal side dfects, and its effects on dopaminergic and serotonergic neurotransmittersystems are unique compared with thoseoftypical antipsychotic medications. The effectiueness ofclozapine and theexplosion ofresearch in neuroscience has led to the investigation qf neurotransmitter systems other than dopam ine as important in developing pharmacologicstrategiesfo r the treatment ofschizophrenia. This paper will review current pharmacologic advances in the treatment ofschizophrenia, and highlight the clinical findings and use qfclozapine, theprototype qfa new generation qfantipsychotic drugs.