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In Alzheimer's disease, decreasing activity of acetylcholine and GABA in the hippocampus and prefrontal cortex are combined with cognitive deficits and with the formation of beta-amyloid. Neurotransmitter alterations in these brain regions are described, while a neurotransmitter imbalance with hypoactivity of muscarinic cholinergic, serotonergic and GABAergic neurons and hyperactivity of noradrenergic and glutamatergic neurons can be found. Serotonin including some specific receptors play an essential role in cognitive symptoms in Alzheimer's disease. Neural networks in the hippocampus and prefrontal cortex are described. Animal experiments and clinical trials about the pro-cognitive effect of 5-HT4 and 5HT7 agonists and of 5-HT3 and 5-HT6 antagonists are mentioned. The question should be investigated, whether a hybrid of a GABAA agonist and an NMDA antagonist is of a therapeutic value in mild Alzheimer's disease.

Schizoaffective disorder is a psychiatric disease with schizophrenic and affective, i.e. depressive, manic or bipolar symptoms. Three cases are presented, while the course of the disease and a different pharmacological treatment are described. The first patient suffers from a recurrent form with bipolar symptoms. The antipsychotic treatment was switched from haloperidol to clozapine with a superior antipsychotic effect and the two moodstabilzing drugs lithium and carbamazepine. The second patient suffers from recurrent schizomanic symptoms and finally the patient is administered the second-generation antipsychotic drug olanzapine, which reduces negative schizophrenic symptoms. The third patient shows recurrent schizomanic symptoms as well. The antipsychotic treatment was switched to quetiapine with a high affinity for the 5-HT2A receptor. The mechanism of action and the adverse effects of the prescribed drugs are pointed out. The patients remained stable, because they adhere to the pharmacological treatment and because they are socially integrated.

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Three cases with different forms of major depression and different pharmacological antidepressant treatments are presented. In the first case report, citalopram, a selective serotonin reuptake inhibitor, improved transient depressive symptoms in a professionally busy man who recovers from the depressive symptoms and solves the social problems in his team. In the second case report showing a severe form of major depression and a suicide attempt, the tricyclic antidepressant drug doxepin failed to improve depressive symptoms. The selective serotonin and noradrenaline reuptake inhibitor venlafaxine partly improved depressive symptoms. Lithium carbonate, a prophylactic drug, which shows antidepressant and antimanic effects, treated depressive symptoms successfully. The cardiac and renal adverse effects were controlled. In the third case report, citalopram was used to treat the chronic form of major depression; however the adverse effects such as sedating and drive-reducing effects and the weight gain were disturbing for the patient. The administration of the selective dopamine and noradrenaline reuptake inhibitor bupropion ameliorated depressive symptoms and sleepiness, however caused hypertension and insomnia. Due to this changed medication, the patient succeeded in coping with a stressful life event, an anti-cancer therapy.