Dopamine is the primary neurotransmitter involved in the pathophysiology of<unk> . Elevated dopamine levels in the neural circuit concerned with neuropsychiatric disorders are postulated to be responsible for the<unk>  and psychosis symptoms and other signs, including fluctuations in body temperatures and fear. Increased extracellular dopamine levels can be caused by low levels of dopaminergic transporters, sensitization of postsynaptic dopaminergic receptors, and dopamine transporters dysfunction. Sagittal cross-section of the brain illustrating the dopaminergic pathway. Role of genetics and signaling pathways<unk>  is a prominent symptom of both bipolar disorder and<unk> . Hence, studying bipolar patients can provide insight into the pathophysiology of this<unk> . PET scans of<unk>  patients illustrate anomalous activation of the dorsal anterior cingulate, right inferior frontal cortical regions.<unk>  symptoms exacerbate with increasing anterior cingulate activation, which is posited to be associated with escalating dopamine transmission in the nucleus accumbens. Dopamine transporter regulates the reuptake of dopamine to keep the synaptic dopamine levels within normal range. Hence, the elevation of such transporter levels in the striatum decreases neurotransmission. Genetic studies have hypothesized a relationship between low transporter protein levels and the gene for dopamine transporter in bipolar affective patients. Stimulant elicited responses Sensitization of postsynaptic dopaminergic receptors External sources contributing to the hypothesized hyperdopaminergic mechanism include psychostimulants like cocaine. These substances provoke behavioral changes similar to<unk> . In chronic users, drug sensitization occurs which induces increased neurotransmission and modified protein expression within the mesolimbic dopamine neurons. Adaptations in dopamine transporters is further triggered causing behavioral sensitization. This phenomenon is not distinct to drug abuse but also other psychomotor stimulants such as stress. Dopaminergic transporters dysfunction Dopaminergic transporters dysfunction is caused by acute<unk>  of bipolar disorder, psychostimulant use, and environmental stress. It is suggested to be common mechanism in excited delirium (EXD). EXD is commonly observed in psychostimulant abusers as these drugs directly impact the dopaminergic transporters, increasing the extracellular dopamine levels. Amplified excitation of the dopaminergic systems can induce extreme fear and magnify both approach and avoidance behaviors. The hyperdopaminergic state triggers aggression, agitation and psychomotor excitement. Additionally, CNS dopamine signaling is active in heart rate, respiration and body temperature regulation. Dopamine imbalance can hence result in hyperthermia, tachycardia, hyperventilation, hypertension and sleep disturbance symptoms.
Bell's mania
Dancing mania
Secondary mania
Myxedema psychosis
Stimulant psychosis
Erotolepsy
Onsan illness
Beck's triad 