Neurotransmitters (NT)
- 1st neurotransmitter discovered:
- Acetylcholine.
Classification
- Class I: Acetylcholine
- Class II: Biogenic amines (e.g., Dopamine, Norepinephrine, Serotonin)
- Class III: Amino acids (e.g., Glutamate, GABA, Glycine)
- Class IV: Gases (e.g., Nitric oxide, Carbon monoxide)
- Mnemonic: AC Ba Aa Ga

- SNc → Substantia Nigra
- Norepinephrine locked in ICU → Locus ceruleus
- ↑↑ Dopamine activity → Madly (Schizophrenia) hunting ()
- ↓↓ GABA → ↓↓ inhibitions → during anxiety () and hunting ()
- Norad → patients becomes anxious ()
- ↓↓ AcH → Alzheimer's, Huntintons (↑↑ in Park)
Condition | NT | Location |
Alzheimer's disease | ↓↓ Acetyl choline | Nucleus basalis of Meynert |
Parkinson's disease | Dopamine ↓↓ ↳ bradykinesia ↑↑ Acetyl choline | Nigrostriatal Mnemonic: Mayil (Meynert) Basil (Basalis) nu Achingum (Acetylcholine) Alzheimersum vannu |
Addiction | Dopamine | Nucleus accumbens Mesolimbic Location ↳ Medial Frontal area ↳ Ventral tegmental area |
ALS | Glutamate Amy → Glue | Hippocampus, Subthalamic nucleus → Memory A-delta fibres → Fast pain |
Huntington's chorea | Dopamine ↑↑ GABA ↓↓ AcH ↓↓ | Loss of GABA in striatum |
Tetanospasmin ↳ spastic paralysis ↳ Presynaptic | GABA | Inhibits release of GABA |
Strychnine ↳ spastic paralysis ↳ Postsynaptic | Glycine Stry → Gly | Inhibits release of glycine. |
Mesocortical | ㅤ | Prefrontal cortex ↳ Motivation ↳ Emotional regulation ↳ Decision making ↳ Memory |
Tuberoinfundibular | Dopamine | • Hypothalamus • Physiologic inhibition of prolactin |
Acetylcholine

ACh release:
- Mediated by SNARE proteins and Ca2+.
- Mnemonic: Snake kandapo snap (Snap 25, Synaptobrevin) cheyth
SNARE proteins | ㅤ |
v-SNARE | Synaptobrevin |
t-SNAREs | Syntaxin + SNAP-25 |
Sequence of Events | Mechanism |
Docking | • v-SNARE interacts with t-SNARE. |
Priming | • ATP Dependent • Complexin binds to the SNARE complex. |
Calcium Influx | • Trigger Action potential • Voltage-gated Ca²⁺ channels open (P/Q-type, N-type) • Ca²⁺ enters presynaptic terminal |
Fusion & Release | • Ca²⁺ binds to Synaptotagmin • Displaces Complexin • Membranes fuse → Pore opens → Ach Release |
- Synaptotagramin
- Ca2+ sensor
- Botulinum toxin
- No release of ACh from excitatory neuron
- Flaccid paralysis

- Clostridium tetani
- Toxin: Tetanospasmin
- Protease → cleaves SNARE
- ⛔ GABA and glycine release from Renshaw cells in spinal cord
- Spastic Paralysis (Lockjaw/Trismus)
- Note: Botulinum toxin

Receptors:
Receptor | Type | Features |
Nicotinic ACh receptor | Ion channel | Fast transmission |
Muscarinic ACh receptor | G-protein-coupled receptor | Metabotropic, Slow transmission |


Biogenic Amines
Norepinephrine

- Synthesized from Dopamine.
- Location:
- Norepinephrine
- Lock in ICU (Locus ceruleus) to give NE
- Function:
- Promotes wakefulness
- Widespread brain area activation
Dopamine Pathways
Pathway | Location | Applied Aspect |
Nigrostriatal | Basal ganglia (Substantia nigra) | ↓ Level of dopamine ↳ Bradykinesia in Parkinson's disease |
Mesolimbic | Medial Frontal area, Ventral tegmental area | Abnormal dopamine pathway at Nucleus Accumbens ↳ Reward pathway ↳ Addiction (Nucleus accumbens) |
Mesocortical | Prefrontal cortex | Motivation, Emotional regulation, Decision making, Memory |
Tuberoinfundibular | Hypothalamus | Physiologic inhibition of prolactin |

- Receptors: D1, D2, D3, D4, D5
- G-protein-coupled receptors (GPCR).
Serotonin (5-hydroxytryptamine, 5-HT)
- Released from: Raphe nuclei
- Receptors:
Type | Type | Location | Function |
5HT 2a | GPCR | Platelet | Platelet aggregation |
5HT 2c | GPCR | GIT | ↓ Food intake (regulate satiety) |
5HT 3 | Ionotropic receptor | Area postrema | Vomiting |
5HT 4 | GPCR | GIT | Peristalsis |
5HT 6,7 | GPCR | Limbic system | ㅤ |
Histamine
- Released from:
- Tuberomammillary nucleus in posterior hypothalamus.
- Location & Function:
- Posterior hypothalamus, Pituitary gland, Pineal gland
- Promote wakefulness.
- Enterochromaffin-like cells (ECL):
- Produce histamine → Act on Parietal cell → increases acid secretion.
- Produce Serotonin → Richest source of serotonin
- Both cause
- Vasodilatation
- ↑ vascular permeability
- Bronchoconstriction


- Mnemonic: His → BC
- HI → Higher functions & Hypersensitivity 1 → ↑↑
- St → Stomach
- B → Brake
- C → Chemotaxis
Amino Acids
Glutamate
- Major excitatory neurotransmitter.
- Function:
- Memory
- Hippocampus
- Subthalamic nucleus
- Only excitatory nucleus of basal ganglia.
- Fast pain
- A-delta fibres
- Receptors:
- AMPA receptor:
- Na+ channel (Depolarization).
- NMDA receptor:
- Ca2+ channel
- Requires glycine to activate
- Mg2+ channel blocks NMDA receptor physiologically.
- It is removed by depolarisation from AMPA

Clinical Aspect
- Mutations:
- Protein C9orf72 (chr 9)
- SOD1 gene mutation
- Converts superoxide → H2O2.
- RNA Binding protein (TDP 43)
- Pathology:
- Most Neurons = Atrophic + Reactive gliosis
- Rest of neurons has Inclusion bodies called Bonina bodies
- Excitotoxicity:
- Seen in Amyotrophic Lateral Sclerosis (ALS)
- Mechanism of action:
- ↑ Ca2+ influx → Cell death
- Rx: Riluzole (NMDA blocker)
GABA (Gamma-Aminobutyric Acid)
- Major inhibitory neurotransmitter.
- Note: GABA is inhibitory by enhancing hyperpolarization.
- Location:
- Basal ganglia
- Mechanism of Action:
- Acts in hyperpolarization phase of action potential
- hyperpolarization → interior of cell more negative

- Applied aspect:
- Loss of GABA in striatum
- Huntington's chorea (involuntary movement).
- Tetanospasmin:
- ⛔ release of GABA from inhibitory neuron
- Presynaptic
Glycine

- Function: Both excitatory & inhibitory.
- Location: α motor neuron.
- Mechanism of Action:
- Feedback inhibition/Renshaw cell inhibition
Clinical aspect:
- Strychnine:
- Inhibits release of glycine.
- Post synaptic
- Glycine is an antagonist of strychnine.
- Both cause Spastic paralysis
- (d/t uninhibited stimulation of α motor neurons → sustained contractions)
Gases
Nitric oxide
- Source: Arginine
- Location: Hippocampus.
- Mechanism of Action:
- Requires cGMP for all action.
- ↑ glutamate release from presynaptic neuron.
- Function: Learning and memory
- Mnemonic: Hippopotamus gas release cheyth
Carbon monoxide
- Source:
- Heme → (Heme oxygenase 2) → CO
- Function:
- Olfaction.
- Pain transmission.
- Learning and memory.