Drugs to treat Schizophrenia and Depression Flashcards
Schizophrenia
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
What are the types of Dopamine receptors?
D1-like family
D2-like family
D1-like family
D1, D5 dopamine receptors
Involve Gs and increase cAMP when activated
D2-like family
D2, D3, and D4 dopamine receptors
Involve Ga and decrease cAMP when activated
What is the Dopamine hypothesis?
People with Schizophrenia have a high number of D2 receptors
The disturbance in Dopamine leads to fantasy issues and perception problems related to Schizophrenia
What role does Dopamine play in the brain?
It plays a role in attention
What are the classifications of anti-psychotic drugs?
Classical
Atypical
Classical anti-psychotic drugs
D2 receptor blockade
Have extrapyramidal side-effects
Effective against positive symptoms
Atypical anti-psychotic drugs
5HT2, D4, and weak D2 blockade
Effective against positive and negative symptoms
What are positive symptoms of Schizophrenia caused by?
Overactivity of the mesolimbic pathway
What are negative symptoms of Schizophrenia caused by?
Mesocortical pathway dysfunction
What are unwanted effects of drugs that treat Schizophrenia?
Parkinsonism
Alkathesia (restlessness)
What is the monamine hypothesis?
Depression was due to a deficiency of neurotransmitters, most notably norepinephrine and serotonin
How many serotonin receptors are there?
14
13 are GPCRs
1 is a ligand activated ion channel
Most drugs that are used as anti-depressants act in what 3 ways?
1) Block monoamine re-uptake
2) Inhibit MAP
3) Inhibit presynaptic autoreceptors
(all act to enhance monoamines)
What are the two types drugs that block transmitter reuptake?
Tyicyclic antidepressants (TCA) Selective Serotonin Reuptake Inhibitors (SSRI)
Tricyclic antidepressants
Non-specific blockers of transmitter reuptake and are muscarinic receptor antagonists
What pharmacological effects do TCAs have on the CNS?
After several weeks, less confusion and mood elevation
What pharmacological effects do TCAs have on the autonomic ns?
Anticholinergic effects - dry mouth, constipation, urinary retention, blurred vision, sexual dysfunction
What pharmacological effects do TCAs have on the cardiovascular system?
Can cause hypotension and arrhythmias
Selective Serotonin Reuptake Inhibitors
More selective for serotonergic systems and also have less anti-muscarinic activity
What are the side effects of SSRIs?
Early onset - nausea, anxiety, agitation, insomnia
Late onset - weight gain, asthenia (weakness), sexual dysfunction, withdrawal
Are TCAs or SSRIs more favorable?
SSRIs
Monoamine Oxidase Inhibitors
Primarily used to treat Parkinsons
Some are used to treat depression
Some are used to treat both
How do Presynaptic autoreceptors work?
Tell the system to stop sending neurotransmitter, so reuptake is blocked
What are some Serotonin receptor antagonists?
Nefrazodone
Trazogone
Mirtazapine
