Synapses, sea slugs, and psychiatry

This year's Nobel Prize in physiology or medicine, announced on 9 October 2000, has gone to Arvid Carlsson, Paul Greengard, and Eric Kandel. The citation states that the prize is shared for pioneering discoveries in slow synaptic transmission, which are “crucial for an understanding of how the normal functioning of the brain and how disturbances in this signal can give rise to neurological and psychiatric diseases” (www.nobel.se/announcement/2000/medicine.html). Carlsson proved the importance of dopamine as a neurotransmitter and subsequently its role in Parkinson's disease and schizophrenia. The strongest pillar of the dopamine theory of schizophrenia is the linear relation between potency of antipsychotic drugs and their dopamine antagonist potential. The theory has taken some knocks recently. A minority of patients remain symptomatic despite the demonstration in vivo using positron and single photon emission tomography of effective dopamine receptor blockade; the efficacy of atypical antipsychotic drugs with low affinity for dopamine receptors; the growing acceptance of a premorbid fall off in the …