antipsychotic facts

Question 1

psychosis

Answer 1

greek for abnormal condition of the mind
used for delusions, hallucinations

Question 2

schizophrenia

Answer 2

affects young people, chronic, strong hereditary factors

Question 3

schizo positive symptoms

Answer 3

From increases DA
-delusions (paranoid)
-hallucinations (voices)
-disordered thoughts
-catatonia

Question 4

Schizo negative symptoms

Answer 4

-withdrawal from social
-loss of emotion
-inability to experience -pleasure (anhedonia)
-motivation issues

Question 5

schizo positive symptoms cause

Answer 5

Glutamate hypofunction on GABAergic neurons in VTA, disinhibits DA in mesolimbic (too much) activating D2

Question 6

Schizo negative symptoms cause

Answer 6

Glutamate hypofunction on DA neurons in the mesocortical pathway leads to under activation of D1
may also be the cause of cognitive impairment

Question 7

schizo treatment

Answer 7

usually D2 antagonists to reduce positive symptoms
need 80% occupancy
-many side effects motor, endocrine, sedative (limits compliance)
-30% are treatment resistant

Question 8

schizo meds side effects

Answer 8

-extrapyramidal motor disturbance
-irreversible dyskinesia (face/limb movement)
-enhanced prolactin
-worsing of negative symptoms (D2 block in cortex)

Question 9

antipsychotic off target mAchR

Answer 9

Block can lead to dry mouth/eye, constipation
but
-Since D2 can affect cholinergic synapses and cause motor issues, a block can prevent this.
-mAchR can also inhibit DA so block and disinhibit further reducing motor issues in striatum

Question 10

antipsychotic off target
5-HT

Answer 10

inhibition of CNS Gi coupled 5-HT receptors
-5-HT2a in nigrostriatal block DA release, these can disinhibit
-in mesocortical circuits 5-HT2a disinhibition can cause DA and glutamate release helping negative symptoms
-in mesolimbic and help counteract increased dopamine function