From dopamine to salience to psychosis--linking biology, pharmacology and phenomenology of psychosis.
Schizophr Res November 1, 2005 Shitij Kapur, Romina Mizrahi, Ming Li 510 citations
Psychosis may arise from the brain incorrectly assigning novelty and importance to ordinary objects and associations, a process linked to dopamine's role in reward prediction and motivational salience. Antipsychotics block dopamine receptors, reducing this aberrant salience and creating a state of detachment from symptoms rather than eradicating them. Contrary to the idea of a delayed onset, improvement is evident within the first few days. The framework accounts for existing data and questions assumptions about antipsychotic action, including their effects in animal models, where they dampen both aberrant and normal motivational salience.