The Glutamate Hypothesis: A Pathogenic Pathway from which Pharmacological Interventions have Emerged

S. R. T. Veerman; P. F. J. Schulte; L. de Haan

doi:10.1055/s-0034-1383657

Pharmacopsychiatry, Inhaltsverzeichnis

Pharmacopsychiatry 2014; 47(04/05): 121-130
DOI: 10.1055/s-0034-1383657

Review

The Glutamate Hypothesis: A Pathogenic Pathway from which Pharmacological Interventions have Emerged

S. R. T. Veerman

¹Mental Health Service Organisation North Holland North, Community Mental Health Division, Flexible Assertive Community Treatment, Alkmaar, The Netherlands

,

P. F. J. Schulte

²Mental Health Service Organisation North Holland North, Division for Specialised Treatment, Treatment Centre for Bipolar Disorders, Alkmaar, The Netherlands

,

L. de Haan

³AMC, Academic Psychiatric Centre, Early Psychosis Department, Amsterdam, The Netherlands

› Institutsangaben

Abstract

We discuss the relevance of the glutamate hypothesis in explaining cognitive disturbances and negative symptoms in schizophrenia. 4 lines of evidence support the hypothesis that glutamate deregulation, mainly through dysfunction of the N-methyl-D-aspartate (NMDA) receptor, is an important underlying mechanism of schizophrenia. Glutamate pathways are promising sites for intervention. Glutamate agonists combined with non-clozapine antipsychotics and glutamate antagonists augmented to clozapine show interesting clinical benefits in refractory schizophrenia. We illustrate how unique properties of the NMDA receptor antagonist memantine in addition to clozapine, may cause improvement of positive, negative and cognitive symptoms of schizophrenia.

Key words

schizophrenia - glutamate - NMDA receptor - clozapine - glycine

Volltext

Referenzen

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