20 UNIT 1 • CURRENT THEORIES AND PRACTICE

Presynaptic Major neurotransmitters have been found to play a role

neuron in psychiatric illnesses as well as in the actions and side
effects of psychotropic drugs. Table 2.1 lists the major neu-
rotransmitters and their actions and effects. Dopamine and
serotonin have received the most attention in terms of the
study and treatment of psychiatric disorders (Tecott &
Presynaptic Smart, 2005). The following sections discuss the major
receptor neurotransmitters associated with mental disorders.

4
Metabolite Enzy 3a
m Reuptake
3b e
1 T 3c
2 is synthesized from tyrosine, a dietary amino acid. Dop-
Postsynaptic
neuron Postsynaptic
receptor
Figure 2.3. Schematic illustration of (1) neurotransmitter
(T) release; (2) binding of transmitter to postsynaptic
receptor; termination of transmitter action by (3a) reuptake
of transmitter into the presynaptic terminal, (3b) enzymatic
degradation, or (3c) diffusion away from the synapse; and
(4) binding of transmitter to presynaptic receptors for
feedback regulation of transmitter release.
metabolized and inactivated by enzymes, primarily mono-
amine oxidase (MAO) (Figure 2.3).
These neurotransmitters are necessary in just the right
proportions to relay messages across the synapses. Studies
are beginning to show differences in the amount of some
neurotransmitters available in the brains of people with
certain mental disorders compared with people who have
no signs of mental illness (Figure 2.4).
Dopamine
Dopamine, a neurotransmitter located primarily in the
brain stem, has been found to be involved in the control of
complex movements, motivation, cognition, and regula-
tion of emotional responses. It is generally excitatory and
amine is implicated in schizophrenia and other psychoses
as well as in movement disorders such as Parkinson’s dis-
ease. Antipsychotic medications work by blocking dop-
amine receptors and reducing dopamine activity.
Norepinephrine and Epinephrine
Norepinephrine, the most prevalent neurotransmitter in
the nervous system, is located primarily in the brain stem
and plays a role in changes in attention, learning and
memory, sleep and wakefulness, and mood regulation.
Norepinephrine and its derivative, epinephrine, are also
known as noradrenaline and adrenaline, respectively.
Excess norepinephrine has been implicated in several anx-
iety disorders; deficits may contribute to memory loss,
social withdrawal, and depression. Some antidepressants
block the reuptake of norepinephrine, whereas others
inhibit MAO from metabolizing it. Epinephrine has lim-
ited distribution in the brain but controls the fight-or-
flight response in the peripheral nervous system.

Dopamine Dopamine
receptor

A Deficient neurotransmitter C Excess neurotransmitter

B Deficient receptors D Excess receptors

Figure 2.4. Abnormal neurotransmission causing some mental disorders because of excess transmission or excess
responsiveness of receptors.

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