Targeting muscarinic receptors to treat schizophrenia

Behav Brain Res. 2021 May 7:405:113201. doi: 10.1016/j.bbr.2021.113201. Epub 2021 Feb 26.

Abstract

Schizophrenia is a severe neuropsychiatric disorder characterized by a diverse range of symptoms that can have profound impacts on the lives of patients. Currently available antipsychotics target dopamine receptors, and while they are useful for ameliorating the positive symptoms of the disorder, this approach often does not significantly improve negative and cognitive symptoms. Excitingly, preclinical and clinical research suggests that targeting specific muscarinic acetylcholine receptor subtypes could provide more comprehensive symptomatic relief with the potential to ameliorate numerous symptom domains. Mechanistic studies reveal that M1, M4, and M5 receptor subtypes can modulate the specific brain circuits and physiology that are disrupted in schizophrenia and are thought to underlie positive, negative, and cognitive symptoms. Novel therapeutic strategies for targeting these receptors are now advancing in clinical and preclinical development and expand upon the promise of these new treatment strategies to potentially provide more comprehensive relief than currently available antipsychotics.

Keywords: Acetylcholine; Dopamine; Muscarinic; Schizophrenia.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antipsychotic Agents / pharmacology*
  • Clozapine / pharmacology*
  • Cognitive Dysfunction / drug therapy*
  • Cognitive Dysfunction / etiology
  • Humans
  • Muscarinic Agonists / pharmacology*
  • Pyridines / pharmacology*
  • Receptors, Muscarinic / drug effects*
  • Schizophrenia / complications
  • Schizophrenia / drug therapy*
  • Schizophrenia / physiopathology
  • Thiadiazoles / pharmacology*

Substances

  • Antipsychotic Agents
  • Muscarinic Agonists
  • Pyridines
  • Receptors, Muscarinic
  • Thiadiazoles
  • xanomeline
  • Clozapine