Potential Noradrenergic Targets for Cognitive Enhancement in Schizophrenia

Abstract

AbstractSubstantial evidence suggests that alterations in noradrenergic function contribute to the cognitive impairments of schizophrenia. Activation of post-junctional α2a-adrenergic receptors in the prefrontal cortex by the α2a-selective agonist guanfacine has demonstrated some preliminary benefit in subjects with schizophrenia treated with atypical antipsychotics. α1-drenergic receptor activity may be less important in mediating the cognitive impairments of schizophrenia, β-adrenergic receptors may serve as another potential target for cognitive remediation in schizophrenia. However, the potential increase in memory consolidation in schizophrenia patients produced by β-adrenergic agonists may be outweighed by the impairment in cognitive flexibility and executive functioning produced by α-adrenergic agonists. Finally, norepinephrine reuptake inhibitors, such as atomoxetine, hold promise as potential cognitive enhancers in schizophrenia because of their ability to indirectly but selectively increase extracellular dopamine concentrations in the prefrontal cortex.