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The coincidence of schizophrenia and Parkinsonism: some neurochemical implications

Published online by Cambridge University Press:  09 July 2009

T. J. Crow*
Affiliation:
Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Harrow, and St Nicholas Hospital, Gosforth, Newcastle upon Tyne
Eve C. Johnstone
Affiliation:
Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Harrow, and St Nicholas Hospital, Gosforth, Newcastle upon Tyne
H. A. McClelland
Affiliation:
Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Harrow, and St Nicholas Hospital, Gosforth, Newcastle upon Tyne
*
1Address for correspondence: Dr T. J. Crow, Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Watford Road, Harrow HA1 3UJ.

Synopsis

The hypothesis has recently been advanced that increased activity of central dopaminergic mechanisms underlies the symptomatology of the schizophrenias. The evidence that dopaminergic transmission in the corpus striatum is impaired in Parkinson's disease suggests that observations on the relationship between Parkinson's disease and schizophrenia may illuminate the pathophysiology of the latter disease. Four cases are reported in which an illness with schizophrenic features developed in the setting of longstanding Parkinson's disease; attention is drawn to earlier reports of schizophrenic illnesses occurring as.postencephalitic sequelae in the presence of a parkinsonian syndrome. These observations appear to conflict with the view that increased dopamine release in the striatum is necessary for the expression of schizophrenic psychopathology, but do not exclude the possibility that increased transmission may occur at other dopaminergic sites in the brain, for example the nucleus accumbens, tuberculum olfactorium or cerebral cortex. Similarly the dopamine receptor blockade hypothesis of the therapeutic effects of neuroleptic drugs cannot be maintained with respect to an action in the striatum in view of the differences between the actions of thioridazine and chlorpromazine in this structure, but may be tenable for actions at extra-striatal sites.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1976

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