The Implications of Adverse Pharmacologic Reactions and Complex Pathogenic Mechanisms in Schizophrenia


  • Puiu Olivian Stovicek Lecturer, Department of Pharmacology, Faculty of Nursing, Târgu Jiu Subsidiary, “Titu Maiorescu” University, Bucharest, Romania
  • Dragoș Marinescu Professor, Academy of Medical Sciences of Romania, University of Medicine and Pharmacy of Craiova Brunch, Craiova, Romania
  • Liana Păuna-Cristian Department of Radiology, Gral Medical Center, Bucharest, Romania
  • Ileana Marinescu Associate Professor, Discipline of Psychiatry, 5th Department, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania



dopamine, extrapyramidal symptoms, homocysteine, prolactin, hypofrontality


Schizophrenia is a major health problem in which diversification and increase in the quality of antipsychotic molecules did not yield the anticipated results. that the etiopathogenesis of schizophrenia accounts for a combination of genetic factors forming the genetic spectrum of vulnerability for schizophrenia. The neurodevelopmental anomalies correlated with the gestational period and obstetric traumatisms raises major pharmacological management issues. The two levels of vulnerability (genetic and neurodevelopmental) are the basis of the pathogeny of side effects induced by antipsychotic medication. The most severe side effects are related to extrapyramidal symptoms, hyperhomocysteinemia, hypofrontality, impairment of the neurovascular unit and neuronal metabolic processes. Understanding these particular mechanisms will allow the clinician to identify the pathogenic model of schizophrenia, customized for each specific case. The adverse drug reaction decreases the compliance and adherence to the treatment, determining repeated discontinuations with psychotic relapses, and may trigger psychopathogenic bursts deteriorating the structural and cerebral functional balance. The type of psychotropic medication must be taken into account, as well as the concomitant medication administered for comorbidities associated with schizophrenia. The cerebral vascular modifications are correlated with the metabolic syndrome induced by antipsychotic medication. This complex syndrome, associated also with modifications in the homocysteine metabolism, determines weight gain, obesity, high blood pressure, ischemic cardiopathy, hyperglycemia and dyslipidemia. Identification of possible biological or neuroimaging markers helps and their early correction may prevent the onset of neurodegenerative evolution and irreversible cerebral atrophies, as well as decrease the risk of side effect that may endanger the life of the schizophrenic patient. The complexity of the pathogenic mechanisms requires a prophylactic behavior, not based on therapeutic switch, but on the proactive, customized pharmacologic intervention, addressing the pathogenic chains.

Author Biographies

Puiu Olivian Stovicek, Lecturer, Department of Pharmacology, Faculty of Nursing, Târgu Jiu Subsidiary, “Titu Maiorescu” University, Bucharest, Romania

Lecturer, Department of Pharmacology, Faculty of Nursing, Târgu Jiu Subsidiary, “Titu Maiorescu” University, Bucharest, Romania

Dragoș Marinescu, Professor, Academy of Medical Sciences of Romania, University of Medicine and Pharmacy of Craiova Brunch, Craiova, Romania

Professor, Academy of Medical Sciences of Romania, University of Medicine and Pharmacy of Craiova Brunch, Craiova, Romania

Liana Păuna-Cristian, Department of Radiology, Gral Medical Center, Bucharest, Romania

Department of Radiology, Gral Medical Center, Bucharest, Romania

Ileana Marinescu, Associate Professor, Discipline of Psychiatry, 5th Department, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania

Associate Professor, Discipline of Psychiatry, 5th Department, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania


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How to Cite

Stovicek, P. O. ., Marinescu, D. ., Păuna-Cristian, L. ., & Marinescu, I. . (2021). The Implications of Adverse Pharmacologic Reactions and Complex Pathogenic Mechanisms in Schizophrenia. BRAIN. Broad Research in Artificial Intelligence and Neuroscience, 12(2), 279-302.

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