26 - Schizoprenia Flashcards
Positive Schizophrenia Symptoms
Hallucinations, delusions, agitation, disorganised thinking
Negative Schizophrenia Symptoms
Introversion, apathy, low self-esteem, personal neglect
Cognitive Symptoms
Poor memory, attention deficit, executive dysfunction
Diagnosis of Schizophrenia
Two (or more) of the following, present for a significant amount of time
Delusions, Hallucinations, Disorganized speech, grossly disorganised, negative symptoms
At least one of the symptoms must be a positive symptom
Persistent for at least 6 months – At least 1 month of active symptoms
BDNF
neurotrophic factor
COMT
dopaminergic transmission
DAOA
glutamatergic transmission
Neuregulin 1
neuroplasticity
Dysbindin
affect dopamine D2 receptor levels and glutamate and GABA transmission
DISC1
neurodevelopment and signalling in corticolimbic areas
What area of the brain does the Wisconsin CardSorting test, test?
Prefrontal Cortex
What may you see in an MRI of a schizophrenic patient
larger ventricles and smaller mesial temporal lobe structures
What occurs in the mesolimbic and mesocortical pathways in schizophrenia?
o Hyperactivity in the mesolimbic pathway
o Hypoactivity in the mesocortical pathway
What receptor do the dopamine antagonists work on
D2
Chlorpromazine
The first neuroleptic
Typical antipsychotics
Chlorpromazine, thioridazine, fluphenazine, haloperidol, flupenthixol
Atypical antipsychotics
Risperidone, olanzapine, clozapine, quetiapine, paliperidone, aripiprazole
At what receptors do atypical AP also have significant antagonist activity at?
5-HT2 receptors
Clozapine
Given in drug resistance
High risk of agranulocytosis
Blocks D4 receptors
Aripiprazole
combines antagonist and partial agonist effects on different D2 receptor
Which other receptors do antipsychotics act on
dopamine d2, alpha1-noradrenergic, serotonin 5-HT2, dopamine D1, histamine H1, muscarinic
What are the EPS
Extrapyramidal effects
Acute dystonias
Parkinsonism
Tardive Dyskinesia
What is neuroleptic malignant syndrome?
o Hyperpyrexia, muscle rigidity, tremor, confusion
What is tardive dyskinesia?
Involuntary movements of the lips, jaw, face – constant chewing, grimacing
Associated mainly w/ typicals taken for more than a few months/years
Which (Atypical or typicals) have more EPS
Typicals
Which antipsychotics can be given as a depot IM injection?
Fluphenazide
Haloperidol
