“…Although it is undoubtedly true that some of the non‐NMDA receptor actions contribute to the behavioural profile of each dissociative compound, there are compelling arguments supporting NMDA receptor antagonism as the likely major contributor to the psychotomimesis: - There is a good correlation between potency of drugs, including between enantiomers, as NMDA receptor antagonists and their psychotomimetic effects in laboratory animals and to a limited extent in man (see above and Figures ).
- Competitive NMDA receptor antagonists share some behavioural effects with phencyclidine‐like compounds, including drug discrimination cues (Koek et al ., ; see Willetts et al ., for critical review), but more importantly have psychotomimetic effects in man (Grotta et al ., ; Herrling, ; Davis et al ., ; Muir, ).
- NMDA receptor antibodies have been implicated in the aetiology of some schizophrenias, although causality is unproven (Deakin et al ., ; Kayser and Dalmau, ; for reviews see Coutinho et al ., ; Pearlman and Najjar, ).
- Genetic risk factors for schizophrenia include several genes that impinge directly or indirectly on NMDA receptor function (Harrison and Weinberger, ; Gilmour et al ., ; Labrie et al ., ; Weickert et al ., ; Harrison, ).
- Genetic manipulations in mice affecting NMDA receptor activity induce (Belforte et al ., ; Labrie et al ., ; Wei et al ., ; Born et al ., ; Takagi et al ., ) or reduce (Hagino et al ., ; Yamamoto et al ., ) aspects of a schizophrenia‐like phenotype.
- Some clinical trials with drugs designed to up‐regulate NMDA receptor function have had positive outcomes (reviewed in Coyle, ). Other manipulations of glutamatergic transmission show promise in animal models and are being assessed therapeutically (reviewed in Javitt, and Dunlop and Brandon, ).
- Agonists of group II metabotropic glutamate receptors reduce hyperlocomotion induced by NMDA receptor antagonists in rats (Moghaddam and Adams, ; Cartmell et al ., ), ketamine‐induced cognitive deficits in man (Krystal et al ., ), and positive and negative symptoms of schizophrenia in man (Patil et al ., ).
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