Clinical and demographic correlates of neuroleptic response

Abstract

This paper presents evidence that the positive symptoms of schizophrenia respond best to neuroleptics, as do patients with hyperdopaminergic activity (high blink rates, low prolactin levels). Those schizophrenics with defect states, intellectual and neurological impairment, brain atrophy, neuropsychological impairment, and poor school and social premorbid adjustment do not respond as well to dopamine blockers. It has been suggested that this group of schizophrenics do not suffer from a dopamine disturbance. There is also evidence for the relatively superior response of women, especially premenopausal women. This may be due to several factors but appears to be related to estrogen levels, especially since psychotic symptoms appear, in some women, premenstrually and post-partum, when estrogen levels drop. There is now substantial evidence that estrogens antagonize dopamine in the brain.