The mechanisms that underlie schizophrenia and influence outcome to antipsychotic treatment are unclear, and remain the focus of intense investigation. Genetic studies have been at the forefront of work to delineate the disorders aetiology and have led to the identification of gene variants, predominantly throughout neurotransmitter pathways, that may be important. Prevailing evidence, however, suggests that those variants so far identified confer a relatively limited influence, and in the search to identify the further participants growing evidence has emerged implicating the involvement of histamine and muscarinic receptor pathways. Studies investigating the genetic contribution of these systems in the disorder are relatively nascent, and consequently the extent to which each may be involved is presently unclear. Further work is, therefore, warranted to determine this role, since these pathways potentially offer an unprecedented insight into the disorders aetiology. It is envisaged this knowledge may also contribute to clarifying the mechanisms that moderate antipsychotic efficacy, and could accelerate ongoing efforts to develop new therapies and predictive pharmacogenetic approaches associated with this area of drug treatment. Drug Dev.