Jefferson Journal of Psychiatry


The treatment of schizophrenia was revolutionized with the introduction of chlorpromaeine in 1952. The effectiveness of chlorpromazine in controlling psychotic symptoms lead to the dopamine Hypothesis of schizophrenia, which revolutionized our conceptualization of this illness. Since that time, numerous typical antipsychotic drugs have been developed for the treatment of schizophrenia. However, the introduction of clozapine in 1990 began a new era in the pharmacologic management of schizophrenia. Clozapine, an atypical antipsychotic drug, is effective in controlling the positive Symptoms of schizophrenia in a large number of otherwise treatment-resistant patients, and also improves the negative symptoms of the illness in marry patients. Clozapine is classified as an atypical antipsychotic drug because it has little potential for causing extrapyramidal side effects, and its effects on dopaminergic and serotonergic neurotransmitter systems are unique compared with those of typical antipsychotic medications. The effectiveness of clozapine and the explosion of research in neuroscience has led to the investigation of neurotransmitter systems other than dopamine as important in developing pharmacologic strategies for the treatment of schizophrenia. This paper will review current pharmacologic advances in the treatment of schizophrenia, and highlight the clinical findings and use of clozapine, the prototype of a new generation of antipsychotic drugs.

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