Psychological Medicine

Research Article

Major psychosis and dopamine: controversial features and some suggestions

Robert Millera1 c1

a1 Department of Anatomy, University of Otago, Dunedin, New Zealand


Three problems with the dopamine hypothesis of major psychosis are pointed out: the long time-course of neuroleptic therapy; the absence of tolerance to the antipsychotic effects of neuroleptic drugs, or of a supersensitivity psychosis on drug withdrawal; and the absence of potent psychotogenic properties in the direct dopamine agonists. A resolution of these paradoxes is suggested relying on a role for dopamine in learning processes at a relatively high (cognitive) functional level. The hypothesis proposed is also used to explain the origin of some of the more distinctive psychotic symptoms.


c1 Address for correspondence: Dr Robert Miller, Department of Anatomy., University of Otago, P.O. Box 913, Dunedin, New Zealand.