Drugs to treat Schizophrenia and Depression

Question 1

What condition is a chronic, disabling brain disorder that affects about 1% of Americans and can cause people to hear voices, see imaginary sights and believe other people are controlling their thoughts?

Answer 1

Schizophrenia

Question 2

Describe positive and negative symptoms.

Answer 2

Positive symptoms = active things linked to excess dopamine (delusions, auditory hallucinations, disturbances in thought)

Negative symptoms = flattening out effects linked to prefrontal pathologies (loss of effect, catatonia, and immobility)

Question 3

The ___ hypothesis states that messages from neurons that transmit dopamine fire either too oftern or too regularly.

Answer 3

dopamine

Question 4

Schizophrenics have high numbers of ___ receptors on the receiving neurons, therefore more dopamine binds to cells.

Answer 4

D2

Question 5

Dopamine is derived from ___ and has ___ different receptor families that recognize ___ different ___ dopamine receptors.

Answer 5

tyrosine; 2; 5; GPCR

Question 6

Dopamine receptors are ___ and the D1 subfamily includes ___ and ___ that are linked to ___ and therefore increase ___.

Answer 6

metabotropic; D1; D5; G-alpha-s; cAMP

Question 7

The D2 subfamily includes ___, ___ and ___ that are linked to ___ and therefore decrease ___.

Answer 7

D2; D3; D4; G-alpha-i; cAMP

Question 8

Which dopamine receptors are found in the stratum?

Answer 8

D1 and D2

Question 9

What is the difference between the classical and atypical neuroleptic drugs?

Answer 9

classical (1st generation) = D2 receptor blockade - antipsychotic action

atypical (2nd generations) = 5HT2, D4 and weak D2 blockade - antipsychotic action

Question 10

Which neuroleptic drug causes extrapyrammidal side effects and hyperprolactinemia (parkinson’s like symptoms)?

Answer 10

Classical, therefore you must treat with more drugs

Question 11

Which drug is effective against positive symptoms? negative symptoms?

Answer 11

positive = classical
negative = atypical

Question 12

Define akathsia.

Answer 12

a subjective sense of restlessness usually (inability to sit) accompanied by mild to moderate motor hyperactivity, usually response to alpha-adrenergic receptor antagonist, anticholinergics, antihistamines, or amantadine.

Question 13

The ___ hypothesis states that depression was due to a deficiency of monoamine neurotransmitters, notably NE and serotonin (5HT).

Answer 13

Monoamine

Question 14

There are 14 serotonin receptors. How many are GPCRs? How many are ligand activated ion channels permeable to Na+ and K+?

Answer 14

13

1

Question 15

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

Answer 15

1. block transmitter reuptake
2. inhibit MAO
3. inhibit presynaptic autoreceptors

All of these serve to enhance the activities of dopamine, 5-HT, and/or NE

Question 16

___ antidepressants are rather non-specific blockers of transmitter ___ that are generally also ___ receptor antagonists. This leads to more side effects

Answer 16

Tricyclic; reuptake; muscarinic

Question 17

Selective ___ reuptake inhibitors are more specific for ___ systems and also have less anti-___ activity.

Answer 17

serotonin; serotonergic; muscarinic

Question 18

T/F. Tricyclic antidepressants are largely superceded by drugs with a better side effects profile.

Answer 18

True.

Initially there is drowsiness, lethargy, anxiety, thought disorders and confusion in CNS
dry mouth, constipation, urinary retention, blurred vision, sexual dysfunciton in autonomics
hypotension; arrhythmias in cardiac

Question 19

T/F. After several week on TCAs, there is less confusion and mood elevation.

Answer 19

True.

Question 20

T/F. SSRI’s are favored over TCAs.

Answer 20

True.

Question 21

What are the side effects of SSRIs?

Answer 21

early onset: nausea, anxiety, agitation, insomnia

late onset: weight gain, asthenia (weakness), sexual dysfunction, withdrawal syndrome

Question 22

MAO inhibitors block the metabolism of what drugs?

Answer 22

dopamine, 5-HT and NE

Question 23

T/F. MAO inibitors are only used to treat depression.

Answer 23

False, some also treat Parkinson’s disease or both

Question 24

___ blocks presynaptic autoreceptors to release more NE release.

Answer 24

Mirtazapine

Question 25

What three anti-depressant drugs are serotonin receptor antagonists?

Answer 25

nefazodone, trazodone, and mirtazapine