Introduction to Psychopharmacology- Dr. Masserano

Question 1

APA: Diagnostic and Statistical Manual of Mental Disorders V

Answer 1

-Disorder that lasts for at least 6 months
-Includes at least 1 month active phase
-At least 2 of the following
Delusions, hallucinations, disorganized speech, grossly disorganized, negative symptoms

Question 2

Delusion

Answer 2

-Misinterpretation of perceptions/experiences

Question 3

Hallucinations

Answer 3

• Usually auditory

- Voice distinct from the person’s own thoughts

Question 4

Disorganized speech (thinking)

Answer 4

• Conversations that slip off the tract

- Loose association

Question 5

Grossly disorganized

Answer 5

-Inability to function in society

Question 6

Negative symptoms

Answer 6

• Affective flattening
• Alogia: poverty of speech
• Avolition: exhaustion
• Anhodonia: without pleasure

Question 7

Dopamine theory of psychoses

Answer 7

• Due to excess dopaminergic activity
• Cocaine, amphetamines, levodopa, can be causative agents
• DA antagonists are clinically effective

Question 8

Mesolimbic pathway

Answer 8

• Hyperactivity = positive symptoms

- D2 blockade

Question 9

Mesocortical pathway

Answer 9

• Hypoactivity = negative symptoms

- Influenced by 5HT

Question 10

Nigrostriatal pathway

Answer 10

• Regulates motor movement

- Side effects: dopamine blockade (Pseudoparkinson)

Question 11

Tuberoinfundibular pathway

Answer 11

• Inhibits prolactin release

- Side effects: dopamine blockade (hyperprolactinemia)

Question 12

Schizophrenia Neurochemistry Theory

Answer 12

• Hyperdoaminergic transmission in the mesolimbic system (causing positive symptoms)
• Hypodopaminergic transmission in mesocortical system (causing negative symptoms)

Question 13

Treatment options

Answer 13

• FGA
• SGA
• All are doamine D2 receptor antagonists

Question 14

Major (unipolar) depression

Answer 14

• Mnemonic = SALSA
• Sleep disturbance
• Anhedonia
• Low self esteem
• Appetite depression

Question 15

SIG E CAPS screening questions

Answer 15

• Sleep decreased
• Interest decreased
• Guilt
• Energy decreased
• Concentration difficulties
• Appetite disturbance
• Psychomotor retardation
• Suicidal thoughts
• Five of nine major positive answers to the above questions everyday for 2 weeks

Question 16

Mania

Answer 16

• Elevated euphoria, self esteem and grandiosity
• Restlessness
• High levels of energy

Question 17

Types of Manic depression (Bipolar) disorder

Answer 17

• Bipolar I
• Bipolar II
• Cyclothmic
• Dysthymic

Question 18

Bipolar I definition

Answer 18

• Mania

- Major depression

Question 19

Bipolar II

Answer 19

• Hypomania

- Major depression

Question 20

Cyclothymic

Answer 20

• Hypomania

- Mild to moderate depression

Question 21

Dysthymic

Answer 21

• Mild or moderate depression

- No discrete episodes

Question 22

Monoamine Theory of Depression

Answer 22

• Due to a lack of CNS 5HT and NE
• Causative agents: Reserpine and Beta blockers
• Treatment agents: TCAs, SSRIs, MAOIs

Question 23

Neurogenesis Theory of Depression

Answer 23

• Stress induced decreases in hippocampal neurogenesis

- Antidepressants can increase neurogenesis over 2 to 3 weeks

Question 24

Possible treatments of depression

Answer 24

• TCAs
• SSRIs
• SNRIs
• Atypical antidepressants
• MAOIs
• ECT

Question 25

Bipolar disorder definition

Answer 25

- Periods of deep, prolonged and profound depression | - Alternates with periods of excessively elevated or irritable mood (Mania)

Question 26

Bipolar MANIC episodes

Answer 26

- One week of profound mood disturbance - At least 3 of the following symptoms: - Grandiosity - Decreased need for sleep - Excessive talking - Racing thoughts - Increased level of goal focused activity - Excessive pleasurable activities

Question 27

Bipolar MAJOR depressive episodes

Answer 27

- 2 weeks experiencing 5 or more of the following - Decreased mood - Diminished pleasure - Weight loss - Hypersomnia/insomnia - Loss of energy - Feeling of worthlessness - Attempted suicide

Question 28

Therapy for Bipolar MAJOR depressive disorder

Answer 28

- Lithium - Anticonvulsants - Antipsychotics

Question 29

Potential side effects with lithium

Answer 29

- Hypothyroid and goiter - Polydispisa and polyuria - Nephrogenic diabetes insipidus

Question 30

Uses of lithium

Answer 30

- Manic depression (bipolar) | - Acute mania

Question 31

Antipsychotic use in depression and bipolar

Answer 31

- Antipsychotics + SSRI - May improve depression - Increases 5HT and NE release by blockade of 5HT2A receptors

Question 32

FDA approved Mood stabilizrs

Answer 32

- Lithium - Valproate - Lamotrigine - Carbamazepine - Fluoxetine + Olanzapine

Question 33

Drugs that are NOT safe in pregnancy

Answer 33

- Valproate - Carbamazepine - Lithium