Abstract
In the course of the last 60 years, pharmacological treatment of schizophrenia focused on varying targets. The concept of schizophrenia itself has changed considerably.
The change in the social context of treatment also influenced targeting of pharmacotherapy in schizophrenia growing respect for human individuality meant greater attention to patient's subjective experience and his compliance with treatment. Effectiveness replaced efficacy as an outcome measure.
Large scale pragmatic trials like CATIE or EUFEST measure the effectiveness better than head to head trials of antipsychotics. Recently, it has been reported, that the interaction of a drug with the dopamine receptor is not a necessary condition for an antipsychotic effect.
This supports the idea that schizophrenia need not necessarily be associated with the dopamine mediated control of stimuli salience.