Drugs for Schizophrenia (Antipsychotics)

Question 1

State the 5 symptoms of schizophrenia

Answer 1

1. positive behaviour subtracted
2. negative behaviour added
3. aggressive symptoms
4. anxiety/depression
5. cognitive symptoms - impaired selevtive attention and working memory

Question 2

State the demographic of onset for schizophrenia

Answer 2

late adolescence or early adulthood

Question 3

dopamine increased/ decreased in acute schizophrenia

Answer 3

increased!!!

Question 4

what is phasic presentation in schizophrenic patients?

Answer 4

phasic presentation = periods of acute presentation with positive symptoms are spread iwth periods of negative symptoms

Question 5

state the causes of schizophrenia

Answer 5

1. genetic predisposition (incomplete hereditary)
2. environmental factors (neurodevelopment abnromalities due to maternal viral infections during pregnancy or obstetrics complication)

Question 6

state the 3 dopamine pathways and their involvement in physiology of perosn

Answer 6

(1) nigrostriatal - produces dopamine -> involved in voluntary movement

(2) mesocortical or mesolimbic - involved in emotion, cognition and attention

(3) tuberoinfundibular (D2/D3) - regulates PRL in blood
- dopamine usually inhibits PRL secretion by binding to D2/3 receptors in anterior pituitary

Question 7

state the 3 theories involved in schizophrenia

Answer 7

1. dopamine theory
2. glutamate theory
3. serotonin theory

Question 8

name the 4 common typical antipsychotics

Answer 8

1. chlorpromazine
2. haloperidol (most commonly used)
3. fluphenazine
4. trifluoperazine

Question 9

state the MOA of the typical antipsychotics

Answer 9

D2 ANTAGONISM

chlorpromazine - D2,M1,H1,A-adrenergic antagonism –> more AE

haloperidol - D2 and A-adrenergic antagonism –> fewer side effects

Question 10

state the AE of typical antipsychotics

Answer 10

• extrapyramidal side effects (tardive dyskinesia, acute dystonia, akathisia)
• antihistamine (h1 receptor antagonism) - sedation, weight gain
• anticholinergic (M1 antagonism) - xerostomia, constipation, blurred vision
• alpha-1 adrenoceptor antagonism - postural hypotension, tachycardia

Question 11

state everything you know about typical antipsychotics
(names, moa, adverse effects)

Answer 11

TYPICAL ANTIPSYCHOTICS
- chlorpromazine, haloperidol, fluphenazine, trifluoperazine

MOA = d2 antagonism
- chlorpromazine - D2,M1,H1,A-adrenergic antagonism –> more AE
- haloperidol - D2,A-adrnergic antagonism –> fewer AE

AE
- extrapyramidal side effects (tardive dyskinesia, akathisia, acute dystonia)
- antihistamine - sedation, wg
- anticholinergic - constipation, xerostomia, blurred vision
- alpha-1 adrenoceptor antagonism - postural hypotension, tachycardia

Question 12

state the 4 common atypical antipsychotics

Answer 12

1. amisulpride
2. clozapine
3. olanzapine
4. risperidone

Question 13

state the criteria to determine whether atypical or typical antipsychotic

Answer 13

presence of 5-ht dopamine antagonism = atypical