This article addresses how neuroimaging can impact the development of and therapy with antipsychotics. The article explains how drug development, disease pathophysiology and neuroimaging approaches can be understood within a single neurobiological framework. It then highlights the relative strengths and applicability of the two streams of neuroimaging: neurochemical neuroimaging that reveals regional concentrations of particular neurochemical species (receptors, transporters or enzymes) and functional neuroimaging that reveals the effects of drug or disease on regional indices of neuronal function such as blood flow and oxygen and glucose metabolism. The application of these techniques is exemplified with recent examples from development and therapeutic use of antipsychotics. To assist decision making in the context of these imaging possibilities, the article presents an algorithm that can be used to guide decisions regarding the application of neuroimaging in the development of and treatment with antipsychotics.
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