13-2 Flashcards
What is the pharmacological drugs for Schizophrenia
Antipsychotic AKA neuroleptic, major tranquilizers
All are D2 receptor antagonists but some block; more potent, less selectively
D2 antagonist
Improves positive symptoms
Extrapyramidal syndrome due to nigrostriatal D2 blockade
Chlorpromazine (Thorazine)
Haloperidol (Haldol)
Side effects (EPS): sustained muscle contractions often developing within 1st week
Dystonia
Side effects (EPS): Parkinsonian symptoms, tremor and shuffling, develop in first few months
Parkinsonism
Side effects (EPS): excessive movements due to inner restlessness, develop in first few months
Akathisia
Side effects (EPS): repetitive, involuntary, purposeless movements, often face and extremities, long-term side effect
Tar dive Dyskinesia
Tachycardia, hypertension, rapid respiration, fever, extreme rigidity, delirium, death
First two weeks of starting meds or ^ dosage
Due to drop in dopamine
Neuroleptic Malignant Syndrome
Antagonists of D2,3,4 and 5-HT2a receptors
Improve positive and negative symptoms
Decrease risk of EPS
Clozaril (clozapine): decrease WBC
Risperidone (risperdal)
Olanzapine (zyprexa)
Additional side effects of all antipsychotics include:
Weight gain, sedation, sexual dysfunction
What are supportive intervention treatments
Vocational rehabilitation
Individual psychotherapy
Family education
Used for medication-refractory Schizophrenia (esp. catatonic type)
ECT augmentation
Which treatment is no longer performed on schizophrenics
Psychosurgery
Surgery that destroys part of the brain in order to change behavior
Psychosurgery
Psychosurgery that crudely severed the prefrontal lobe by Monica in mid-1930s
Prefrontal lobotomy
Prefrontal lobotomy used by Freeman
Transorbital lobotomy
1 month of active-phase symptoms and signs of disturbance last LESS than 6 months
Schizophreniform Disorder
1 CORE symptom, last <1 month, returns to full premorbid functioning
*w/ or w/o marked stressor
Brief Psychotic Disorder
Presence of delusion, symptoms >1 month, no other psychotic domain symptoms, no functional impairment aside from direct impact of delusion
Delusional Disorder
What are the subtypes of Delusional Disorder
Persecutory
Grandiose
Erotomanic
Jealous
Somatic
Unspecified
Belief that involves something that could occur in real life, belief physically possible
Non-bizarre delusion
Belief that clearly implausible and not derived from ordinary life experiences
Bizarre delusion
Treatments for Delusional Disorders
Antipsychotics
Trial separation from partner
Increasing sources of reality testing
Delusion develops in context of close relationship with psychotic individual and believes the same delusion as psychotic
Delusional Disorder (formerly Shared Psychotic Disorder)
Active phase of Schizophrenia occurs concurrently with major mood episode (MDE or manic episode)
Active phase >2 weeks WITHOUT mood symptoms
Mood symptoms present majority of total duration of symptomatic periods of illness
Schizoaffective Disoder
Subtype of Schizoaffective disorder
Bipolar type (if mania is experienced)
Depressive type (if depression is experienced but not mania)
What is the etiology of other Psychotic Disorders?
Unknown but thought to overlap with schizophrenia
What is the treatment for Psychotic Disorders?
All usually treated with antipsychotic medications and supportive psychotherapeutic/psychosocial interventions
What are shorthand approach to diagnosis of schizoaffective disorder
Concurrent psychosis and mood?
Psychosis alone?
Mood symptoms duration proportional with psychotic symptoms duration?
