It is widely accepted that
cholinergic activity at
muscarinic receptors is required to maintain cognitive functions, including learning and memory. Memory domains are especially impaired in
schizophrenia, which may explain difficulties in psychosocial rehabilitation of individuals with this illness. However, little is known about the mechanism of this impairment. To understand our current knowledge, we reviewed the literature since 1990 via a PubMed search for the terms "
muscarinic", "
schizophrenia", "cognition", "memory", "learning", and "agonist" in combination. We found 89 basic science/laboratory studies, case reports/series, case-control studies, cross-sectional studies, standardized controlled animal trials, standardized controlled human trials, and reviews. Although further research is required to fully understand the neuropharmacology of the
cholinergic system in cognitive function in
schizophrenia, we have examined the data currently available. In general, these data suggest that agonist activity at
acetylcholine muscarinic type 1 (M1) receptors would enhance memory and learning in
schizophrenia. We present an overview of likely side effects of
muscarinic agonists. We outline the
anticholinergic activity of several available
antipsychotics and review the available M1
muscarinic agonists.