Drugs to treat Schizophrenia and Depression

Question 1

Schizophrenia

Answer 1

A long-term mental disorder involving a breakdown in the relationship between thought, emotion, and behavior, leading to a faulty perception, inappropriate actions and feelings, withdrawal from reality and personal relationships into fantasy and delusion

Question 2

What are the types of Dopamine receptors?

Answer 2

D1-like family

D2-like family

Question 3

D1-like family

Answer 3

D1, D5 dopamine receptors

Involve Gs and increase cAMP when activated

Question 4

D2-like family

Answer 4

D2, D3, and D4 dopamine receptors

Involve Ga and decrease cAMP when activated

Question 5

What is the Dopamine hypothesis?

Answer 5

People with Schizophrenia have a high number of D2 receptors

The disturbance in Dopamine leads to fantasy issues and perception problems related to Schizophrenia

Question 6

What role does Dopamine play in the brain?

Answer 6

It plays a role in attention

Question 7

What are the classifications of anti-psychotic drugs?

Answer 7

Classical

Atypical

Question 8

Classical anti-psychotic drugs

Answer 8

D2 receptor blockade
Have extrapyramidal side-effects
Effective against positive symptoms

Question 9

Atypical anti-psychotic drugs

Answer 9

5HT2, D4, and weak D2 blockade

Effective against positive and negative symptoms

Question 10

What are positive symptoms of Schizophrenia caused by?

Answer 10

Overactivity of the mesolimbic pathway

Question 11

What are negative symptoms of Schizophrenia caused by?

Answer 11

Mesocortical pathway dysfunction

Question 12

What are unwanted effects of drugs that treat Schizophrenia?

Answer 12

Parkinsonism

Alkathesia (restlessness)

Question 13

What is the monamine hypothesis?

Answer 13

Depression was due to a deficiency of neurotransmitters, most notably norepinephrine and serotonin

Question 14

How many serotonin receptors are there?

Answer 14

14
13 are GPCRs
1 is a ligand activated ion channel

Question 15

Most drugs that are used as anti-depressants act in what 3 ways?

Answer 15

1) Block monoamine re-uptake
2) Inhibit MAP
3) Inhibit presynaptic autoreceptors
(all act to enhance monoamines)

Question 16

What are the two types drugs that block transmitter reuptake?

Answer 16

Tyicyclic antidepressants (TCA)
Selective Serotonin Reuptake Inhibitors (SSRI)

Question 17

Tricyclic antidepressants

Answer 17

Non-specific blockers of transmitter reuptake and are muscarinic receptor antagonists

Question 18

What pharmacological effects do TCAs have on the CNS?

Answer 18

After several weeks, less confusion and mood elevation

Question 19

What pharmacological effects do TCAs have on the autonomic ns?

Answer 19

Anticholinergic effects - dry mouth, constipation, urinary retention, blurred vision, sexual dysfunction

Question 20

What pharmacological effects do TCAs have on the cardiovascular system?

Answer 20

Can cause hypotension and arrhythmias

Question 21

Selective Serotonin Reuptake Inhibitors

Answer 21

More selective for serotonergic systems and also have less anti-muscarinic activity

Question 22

What are the side effects of SSRIs?

Answer 22

Early onset - nausea, anxiety, agitation, insomnia

Late onset - weight gain, asthenia (weakness), sexual dysfunction, withdrawal

Question 23

Are TCAs or SSRIs more favorable?

Answer 23

SSRIs

Question 24

Monoamine Oxidase Inhibitors

Answer 24

Primarily used to treat Parkinsons
Some are used to treat depression
Some are used to treat both

Question 25

How do Presynaptic autoreceptors work?

Answer 25

Tell the system to stop sending neurotransmitter, so reuptake is blocked

Question 26

What are some Serotonin receptor antagonists?

Answer 26

Nefrazodone
Trazogone
Mirtazapine