CNS Pharmacology I- schizophrenia and depression

Question 1

The positive symptoms (positive or excitatory mechanisms) of schizophrenia are linked to what?

Answer 1

Excess dopamine

Question 2

The negative symptoms of schizo are linked to what?

Answer 2

Prefrontal pathologies

Question 3

Dopamine receptors are what kind of receptors?

Answer 3

G-protein coupled receptors

Question 4

D1 type dopamine receptors are linked to an increase in what?

Answer 4

cAMP

Question 5

D2 type dopamine receptors are linked to a decrease in what?

Answer 5

cAMP

Question 6

Schizo probably involves multiple neurotransmitter system abnormalities.

Answer 6

For sure

Question 7

There’s a slide on classical versus atypical antipsychotics- the classical antipsychotic can have extrapyramidal side effects which is like what disease?

Answer 7

Parkinson’s like symptoms can result

Question 8

What are some other adverse effects of anti-psychotics?

Answer 8

sedative, parkinson like symptoms, weight gain, anti-muscarinic, orthostatic hypotension, blurred vision, constipation, decreased secretion- dry mouth

Question 9

What is the biochemical basis of depression- what is the monoamine hypothesis?

Answer 9

Depression is due to a deficiency of monoamine neurotransmitters, especially nor-epi and serotonin

Question 10

Depression is due to a lack of norepinephrine and serotonin, so in what ways would drugs work to treat depression (anti depressants)

Answer 10

Block neurotransmitter reuptake
Inhibit monoamine oxidase
Inhibit presynaptic autoreceptors

Question 11

Why would blocking neurotransmitter reuptake work on treating depression?

Answer 11

It prolongs the activity of the neurotransmitter that is there- the best ones are the selective serotonin reuptake inhibitors (SSRIs) which are more specific for serotonergic systems

Question 12

What are the side effects of anti-cholinergic drugs?

Answer 12

sedation, blurred vision, constipation, urinary retention, cardiac abnormalities, photosensitivity, weight gain, dry mouth, nausea

Question 13

In blocking transmitter reuptake, there are these things called tricyclic antidepressants. What are they?

Answer 13

They are rather non-specific blockers of transmitter reuptake. Significant side effects result.

Question 14

What are the side effects of TCAs (tricyclic antidepressants)

Answer 14

Initially its drowsiness, lethargy, anxiety, thought disorders and confusion. These symptoms decrease a bit over time.

Question 15

What are the side effects of SSRI’s?

Answer 15

Early on:
Nausea, anxiety, agitation, insomnia
Later: weight gain, asthenia, sexual dysfunction, withdrawal syndrome

Question 16

Which is better TCA or SSRI?

Answer 16

SSRI

Question 17

Mono amine oxidase inhibitors do what?

Answer 17

They oxidize the monoamines.

Question 18

What happens if you inhibit an MAO?

Answer 18

It won’t oxidize or metabolize dopamine, 5-HT or norepinephrine, lengthening their effects

Question 19

Another way to treat depression is to block the presynaptic auto receptors. Why does this work?

Answer 19

The auto receptors, when bound by the agonist, block the release neurotransmitter into the synaptic cleft. If you block the auto receptors then the neurotransmitter will continue to be released.

Question 20

Most drugs that are used as anti-depressants act in one of three ways- what are they?

Answer 20

1. Block transmitter reuptake
2. Inhibit MAO
3. Inhibit presynaptic autoreceptors