Antipsychoses Flashcards
Etiology: of schizophrenia
Stress diathesis
Biological (transmethylation,serotonin,da, hypothesis)
Psychological
serotonin hypothesis
Blockade of the 5HT2A-receptor
( clozapine, quetiapine)
> release da, ne, gluatamate, GABA, Ach
Dopamine hypothesis
Blockade d2 cns receptor (mesolimbic-mesocortical pathway)
Mesolimbic pathway
Positive symptoms
Mesocortical pathway
Negative and cognitive symptoms
Glutamate hypothesis
Decrease glutamate transmission
Fewer receptor in the prefrontal cortex and hippocampus
INHIBITS NMDA GLUTAMATE RECEPTORS
+ - high doses symptoms
ABUSE OF PHENCYCLIDINE (ANGEL DUST)
Glycine modulatory site on NMDA RECEPTOR
reduction in negative symptoms cognitive and positive in glutamate hypo. (CLOZAPINE)
Type 1 -acute schizo
Positive symptoms (hallucination, delusions) good prognosis..
Type 2-chronic schizo
Negative symptoms .. less prognosis
Phenothiazines derivatives:
Aliphatic- clorpromazine(prototypye)
Piperadine-(thioridazine)
Piperazine-(fluphenazine)
Aliphatic and piperadine less potent(sedation &weightgain)
Piperazine more potent(effective lower dose)
Haloperidol
Butyrophenone(fewer autonomic) greater extrapyramidial effect.
Typical antipsycho drugs
Miscalleanous: PIMOZIDE AND MOLINDONE
2nd gen antipsycho
CLOZAPINE- PROTOTYPE
Glutamatergic antipsycho
BITOPERTIN AND SARCOSERINE
(Grreater 5-HT2A RECEPTOR) Than with D2
Class of atypical potent in D2 and D3 but also 5HT7 Antagonist
SULPRIDE AND SULPIRIDE
(Increase SERUM PROLACTIN) tardive dyskinesia