The Possible Role of the Angiotensin System in the Pathophysiology of Schizophrenia: Implications for Pharmacotherapy
UMass Chan Affiliations
School of MedicinePsychotic Disorders Program, UMass Memorial Medical Center
Implementation Science and Practice Advances Research Center
Department of Psychiatry
Document Type
Journal ArticlePublication Date
2019-06-01Keywords
Amino Acids, Peptides, and ProteinsBiochemical Phenomena, Metabolism, and Nutrition
Cellular and Molecular Physiology
Mental and Social Health
Mental Disorders
Nervous System
Neuroscience and Neurobiology
Pharmacology, Toxicology and Environmental Health
Psychiatry
Psychiatry and Psychology
Therapeutics
Metadata
Show full item recordAbstract
A growing body of literature has elucidated the involvement of the central renin-angiotensin system (RAS) in various neuropsychiatric diseases. While consensus on the exact mechanism of the central RAS in schizophrenia pathophysiology does not currently exist, increasing evidence reveals promise in harnessing the therapeutic potential of RAS modulation in the treatment of schizophrenia. In this review, we examine how the central RAS affects inflammation, glutamate, dopamine, gamma-aminobutyric acid (GABA), and peroxisome proliferator-activated receptor (PPAR)-gamma, all of which are associated with schizophrenia etiology. In addition, a recent study has demonstrated the therapeutic potential of RAS modulators, especially angiotensin II type 1 receptor blockers (ARBs), as adjunctive therapy to the currently available antipsychotic medications for schizophrenia treatment. With a greater understanding of how RAS inhibition directly modulates neurotransmitter balance in the brain, it is possible that compounds with RAS-inhibiting properties could be used to optimize physiological levels of glutamate, dopamine, and GABA, and the balance among the three neurotransmitters, analogously to how antipsychotic medications mediate the dopaminergic pathways. It can be hoped that a novel approach based on this concept, such as adjunctive telmisartan therapy, may offer practical interventional strategies to address currently unmet therapeutic needs in patients with schizophrenia, especially those with treatment-resistant schizophrenia.Source
CNS Drugs. 2019 Jun;33(6):539-547. doi: 10.1007/s40263-019-00632-4. Link to article on publisher's site
DOI
10.1007/s40263-019-00632-4Permanent Link to this Item
http://hdl.handle.net/20.500.14038/46305PubMed ID
30993607Related Resources
ae974a485f413a2113503eed53cd6c53
10.1007/s40263-019-00632-4