Schizophrenia is a serious mental disorder with a challenging rational
pharmacotherapy. Neurochemical transmission in the dopaminergic system,
especially via D2 receptors, and related changes in postsynaptic signal
transduction are very important in both the formation of schizophrenia and
current pharmacotherapeutic treatment with antipsychotic drugs. Blocking the
serotonergic 5-HT2A and 5-HT2C receptors is growing growing importance with
regard to the action mechanisms of new generation antipsychotic
medications. Recent preclinical and clinical data show that dysfunction of
central neurotrophins, such as nerve growth factor (NGF), brain-derived
neurotrophic factor (BDNF), and neurophin-3 (NT-3) might contribute to impaired
brain development and neuroplasticity, leading to schizophrenia. In addition,
some recent studies suggest that there is an important relationship between
alcohol and substance addiction, and schizophrenia. There is also some
preclinical data indicating that the central nitrergic system and agmatine¾a
biologically active agent produced after decarboxylation of arginine¾might
be interesting and important targets for understanding the etiopathogenesis of
schizophrenia and for development of new drugs. Selective dopamine D3 receptor
antagonists, specific agonists for metabotropic and NMDA receptors of the
glutamatergic system, and nicotinic α-7 receptor agonists were reported in
preclinical and a limited number of clinical studies as potential new targets
for schizophrenia treatment. In this review, new advances in the pharmacotherapy
of schizophrenia and possible new targets are discussed in the light of the
current literature.