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The dopamine hypothesis of schizophrenia is examined critically. Although the hypothesis is couched in chemical terms, the evidence is primarily pharmacologic. In addition, neuroleptic mechanisms do not fit a simple hyperdopaminergic formulation, and treatment efficacy points to a general psychotic rather than specific schizophrenic role for dopamine. Most compromising to the hypothesis is the therapeutic action of L-dopa when combined with neuroleptics in chronic schizophrenics. Dopamine appears important but cannot be viewed as a simple pathogen.

At Issue: An Un-Dopamine Hypothesis of Schizophrenia