The effectiveness of most if not all existing antipsychotic medications in stopping auditory hallucinations and other psychotic symptoms depends on blocking the action of the neurotransmitter dopamine at a class of dopamine receptors in the brain called D2. (This is undoubtedly an oversimplification but it is the basis of most therapeutic approaches to schizophrenia and other psychotic illnesses.)
However, blockade of D2 receptors cannot be limited to the region of the brain where the dopamine activity causes psychotic symptoms, and furthermore the existing drugs affect other neurotransmitters as well, causing distressing and morbid side effects.
What if, instead of blocking D2 receptors, it were possible simply to decrease the numbers of D2 receptors in the pertinent brain areas? Researchers at St Jude’s Children’s Research Hospital reported in Nature Medicine that they have done just that (in a mouse model) with a piece of RNA that regulates the body’s manufacture of the protein constituting the D2 receptor. This promises a potentially cleaner, more effective and more tolerable therapy for voices and other psychotic distress.
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