All Roads to Schizophrenia Lead to Dopamine Supersensitivity and Elevated Dopamine D2High Receptors
Open accessAbstract
BACKGROUND: The dopamine D2 receptor is the common target for antipsychotics, and the antipsychotic clinical doses correlate with their affinities for this receptor. Antipsychotics quickly enter the brain to occupy 60-80% of brain D2 receptors in patients (the agonist aripiprazole occupies up to 90%), with most clinical improvement occurring within a few days. The D2 receptor can exist in a state of high-affinity (D2(High) ) or in a state of low-affinity for dopamine (D2Low). AIM: The present aim is to review why individuals with schizophrenia are generally supersensitive to dopamine-like drugs such as amphetamine or methyphenidate, and whether the D2(High) state is a common basis for dopamine supersensitivity in the animal models of schizophrenia. RESULTS: All animal models of schizophrenia reveal elevations in D2(High) receptors. These models include brain lesions, sensitization by drugs (amphetamine, phencyclidine, cocaine, corticosterone), birth injury, social isolation, and gene deletions in pathways for NMDA, dopamine, GABA, acetylcholine, and norepinephrine. CONCLUSIONS: These multiple abnormal pathways converge to a final common pathway of dopamine supersensitivity and elevated D2(High) receptors, presumably responsible for psychotic symptoms. Although antipsychotics alleviate psychosis and reverse the elevation of D2(High) receptors, long-term antipsychotics can further enhance dopamine supersensitivity in patients. Therefore, switching from a traditional antipsychotic to an agonist antipsychotic (aripiprazole) can result in psychotic signs and symptoms. Clozapine and quetiapine do not elicit parkinsonism or tardive dyskinesia because they are released from D2 within 12 to 24 h. Traditional antipsychotics remain attached to D2 receptors for days, preventing relapse, but allowing accumulation that can lead to tardive dyskinesia. Future goals include imaging D2(High) receptors and desensitizing them in early-stage psychosis.
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Increased striatal D2 receptors may result in D2 receptor supersensitivity in the ventral striatum contributing to psychosis.
“which may result in D2 receptor supersensitivity in the ventral striatum contributing to psychosis [79].”
From Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings (2012) · cites this paper as [79]
Studies suggest an increased affinity of D2 receptors for DA in schizophrenia, which may produce a D2 receptor supersensitivity in the NAc contributing to psychosis.
“Studies have also suggested an increased affinity of D2 receptors for DA in schizophrenia, that may produce a D2 receptor supersensitivity in the NAc contributing to psychosis [79].”
From Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings (2012) · cites this paper as [79]
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- Authors
- Seeman, P.
- Affiliations
- University of Toronto (CA)
- Corresponding author
- Seeman, Philip
- ORCID
- Seeman, Philip
- Venue
- CNS Neuroscience & Therapeutics
- Publisher
- Wiley
- Published
- 2011-03-15
- Volume
- 17
- Issue
- 2
- Pages
- 118-132
- ISSN
- 1755-5930 (ISSN-L)
- PMC
- PMC6493870
- OpenAlex
- W2113742168
- Cited by
- 228
- References
- 104
- Citations by year
- 2026: 11 · 2025: 5 · 2024: 5 · 2023: 4 · 2022: 16 · 2021: 12 · 2020: 17 · 2019: 9 · 2018: 9 · 2017: 18 · 2016: 23 · 2015: 22 · 2014: 16 · 2013: 23 · 2012: 21
- FWCI
- 13.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- CNS Neuroscience & Therapeutics (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Receptor Mechanisms and Signaling
- Keywords
- schizophrenia, dopamine D2 receptor, dopamine supersensitivity, animal models of schizophrenia, antipsychotic drugs, aripiprazole, tardive dyskinesia, parkinsonism, amphetamine sensitivity, phencyclidine, birth trauma, social isolation, gene deletion, NMDA receptor, GABA, acetylcholine, norepinephrine, receptor desensitization, psychosis
- MeSH terms
- Animals, Brain, Disease Models, Animal, Dopamine, Gene Expression Regulation, Humans, Schizophrenia, Antipsychotic Agents, Receptors, Dopamine D2
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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