Here, we describe the alterations of classical neurotransmitters and
neuropeptides, acting at specific subreceptors, in the brain regions involved in affective
and schizophrenic symptoms in the schizoaffective disorder. In schizophrenic
symptoms, alterations of the postsynaptic excitatory neurotransmitters dopamine and
serotonin and hypoactivity of the presynaptic inhibitory neurotransmitter GABA and of
glutamate occur in the mesolimbic system, hippocampus and prefrontal cortex.
Neuropeptides, such as neurotensin, cholecystokinin and substance P act as
neuromodulators. In depressive symptoms, brain regions such as the brainstem,
hypothalamus and hippocampus are involved. Serotonin, dopamine, acetylcholine,
GABA and glutamate play an important role. Neuropeptides such as galanin,
neuropeptide Y and substance P are involved in the pathophysiology of the affective
symptoms. Because schizophrenic and affective symptoms can be enhanced by stressful
events or traumatisms, the hypothalamic-adrenal axis and its efferent connections to the
brainstem and hippocampus are considered. We suggest additional pharmacotherapies
for the treatment of the disease interfering with specific subreceptors of the classical
neurotransmitters and neuropeptides described.
Keywords: Acetylcholine, antipsychotic drug, brainstem, cholecystokinin,
dopamine, galanin, gastrin-releasing peptide, gamma-aminobutyric acid,
glutamate, hippocampus, hypothalamus, hypothalamic-adrenal axis, moodstabilizing
drug, neural network, neuropeptide Y, neurotensin, prefrontal cortex,
serotonin, tachykinin, ventral tegmental area.
