Dopamine System Stabilizers, Aripiprazole, and the Next Generation of Antipsychotics, Part 2: Illustrating Their Mechanism of Action

A new class of antipsychotics, called dopamine system stabilizers (DSSs), is in research and development and could become the next generation of treatment for schizophrenia and psychotic illnesses. On the one hand, DSSs reduce dopaminergic neurotransmission when dopamine is excessive in the limbic system; on the other hand, these agents maintain or enhance dopaminergic neurotransmission so that it is in the normal range in motor areas of the brain (the nigrostriatal system). DSSs thus reduce the hyperactivity of dopamine neurons that mediate psychosis and at the same time restore dopamine activity in the cortical regions that mediate negative and cognitive symptoms as well as the brain areas that regulate motor movements and prolactin.