OBJECTIVE: Phencyclidine (PCP, "angel dust") induces a psychotomimetic
state that closely resembles schizophrenia. As opposed to amphetamine-
induced psychosis, PCP-induced psychosis incorporates both positive (e.g.,
hallucinations, paranoia) and negative (e.g., emotional withdrawal, motor
retardation) schizophrenic symptoms. PCP-induced psychosis also uniquely
incorporates the formal thought disorder and neuropsychological deficits
associated with schizophrenia. The purpose of the present paper is to
review recent advances in the study of the molecular mechanisms of PCP
action and to describe their implications for the understanding of
schizophrenic pathophysiology. METHOD: Twenty- five papers were identified
that described the clinical dose and serum and CSF levels at which PCP
induces its psychotomimetic effects. The dose range of PCP-induced effects
were compared to the dose range at which PCP interacts with specific
molecular targets and affects neurotransmission. RESULTS: It was found that
PCP-induced psychotomimetic effects are associated with submicromolar serum
concentrations of PCP. At these concentrations PCP interacts selectively
with a specific binding site (PCP receptor) that is associated with the
N-methyl-D-aspartate (NMDA)-type excitatory amino acid receptor. Occupation
of its receptor by PCP induces noncompetitive inhibition of NMDA
receptor-mediated neurotransmission. Other NMDA antagonists such as the
dissociative anesthetic ketamine induce PCP- like neurobehavioral effects
in proportion to their potency in binding to the PCP receptor and inducing
NMDA receptor inhibition. CONCLUSIONS: These findings suggest that
endogenous dysfunction of NMDA receptor- mediated neurotransmission might
contribute to the pathogenesis of schizophrenia. The relative implications
of the PCP and amphetamine models of schizophrenia are discussed in
relationship to the diagnosis and etiology of schizophrenia.
Abstract Teaser