The Importance of Dopamine In The Treatment Of Schizophrenic and Prodromal Patients

Abstract

Schizophrenia, a debilitating mental illness, manifests during late adolescence or early adulthood, persisting throughout an individual’s life and significantly impacting their quality of life. Characterized by positive symptoms such as hallucinations and delusions, negative symptoms including asociality and cognitive impairment, schizophrenia affects approximately 1% of the global population across ethnic, economic, and cultural boundaries. Despite advancements in understanding its prodromal stages, two-thirds of patients fail to regain their prior level of functioning post-first psychotic episode. Moreover, schizophrenia is associated with a reduced life expectancy by 15 years. This review synthesizes current literature on schizophrenia, emphasizing its prodromal stages, including Early Initial Prodromal Stage (EIPS) and Late Initial Prodromal Stage (LIPS). Transition rates from prodromal to psychotic episodes highlight the urgent need for effective interventions. Treatment predominantly relies on antipsychotics, targeting dopamine receptors, particularly dopamine D2 receptors. While First Generation Antipsychotics (FGAs) primarily address positive symptoms, they are limited by adverse effects. Second Generation Antipsychotics (SGAs) offer reduced extrapyramidal motor side effects but are associated with metabolic burden and weight gain. This review introduces ITI-007 as a promising therapeutic agent for LIPS, providing a safer alternative to SGAs. By exploring the role of dopamine in schizophrenia, the review underscores the importance of addressing both positive and negative symptoms. Non-pharmacological interventions are effective in EIPS but may not suffice for LIPS, necessitating pharmacological approaches. Through a comprehensive examination of current treatment strategies and emerging alternatives, this review aims to contribute to the development of targeted interventions for individuals at risk of schizophrenia and improve long-term outcomes.