Which neurochemical pattern is described for schizophrenia?

• A. Increased dopamine and decreased serotonin
• B. Decreased dopamine and increased serotonin
• C. Increased GABA
• D. Decreased dopamine and decreased serotonin

Answer: (A)

Dopaminergic overactivity in schizophrenia is the driving clue, with serotonin acting as a modulator of that system. Positive symptoms like delusions and hallucinations are linked to increased dopamine activity in the mesolimbic pathway. Antipsychotic medications that block D2 receptors reduce these symptoms by dampening dopamine signaling in that circuit. Serotonin’s role is modulatory: many second-generation antipsychotics block 5-HT2A receptors, which helps balance dopamine release in other pathways and can improve several symptoms and side effects. So describing the pattern as increased dopamine with decreased serotonin fits the idea that dopamine drives psychosis while serotonin dysfunction contributes to the broader neurochemical imbalance.

The other patterns don’t align with what we see in schizophrenia. A decrease in dopamine wouldn’t account for prominent positive symptoms, and a straightforward increase in serotonin isn’t the primary driver described in most pharmacologic models. Increased GABA isn’t the hallmark pattern associated with schizophrenia either, since GABAergic changes are more nuanced and not the central driver of the classic symptom profile.