The Top 5 Neurotransmitters from a Clinical Neurologist’s Perspective

Neurologists are proficient in neuroanatomy and –physiology but their understanding of neurochemistry tends to be mediocre. As a rule, we do not think in biochemical pathways and complex metabolic interactions but rather associate a few neurotransmitters with well-known brain diseases or drugs that we routinely prescribe. Most of us can hardly come up with more than a handful of relevant neurochemicals. From our point of view the most important neurotransmitters are, in alphabetical order, acetylcholine (associated with Alzheimer’s disease and myasthenia gravis), dopamine (Parkinson’s disease), glutamate and GABA (epilepsy and seizures), and serotonin (major depression; although this is arguably the domain of psychiatrists). In this commentary, the author presents the knowledge derived from neurochemistry research that has proven useful for clinical neurological practice. In addition, he explains what biochemists, basic neuroscientists and other non-neurologists need to consider in the encounter with a clinical neurologist.