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Psychopharmacology > Lecture 12 Schizophrenia and Antipsychotics > Flashcards

Lecture 12 Schizophrenia and Antipsychotics Flashcards

1
Q

What percent of the worlds population has schizophrenia?

A

1%

1/3 of homeless people have schizophrenia

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2
Q

When is the onset of schizophrenia?

A

Late adolescence and early adulthood suggesting a developmental factor

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3
Q

What is the ratio of male to female that have schizophrenia?

A

1.4(M)/1(F)

Males tend to show symptoms earlier

likely a result of gene x environment interactions

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4
Q

Name 5 subtypes of schizophrenia

A 
Paranoid
Catatonic
Disorganized
Undifferentiated
Residual
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5
Q

What is the primary symptom of paranoid schizophrenia?

A

Delusions

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6
Q

What is the primary symptom of catatonic schizophrenia?

A

Immobility

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7
Q

What is the primary symptom of disorganized schizophrenia?

A

Inappropriate emotional expression, immaturity

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8
Q

What is the primary symptom of of undifferentiated schizophrenia?

A

no specific pattern of symptoms

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9
Q

What is the primary symptom of residual schizophrenia?

A

Spontaneous remission of symptoms

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10
Q

What are the positive symptoms of schizophrenia?

A

Hallucinations, delusions of persecution and grandeur, bizarre behavior.

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11
Q

What are the negative symptoms of schizophrenia?

A

Social withdrawal, anhedonia, decreased mobility, flat affect, poor hygiene

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12
Q

What are cognitive deficits of schizophrenia?

A

Deficits in working memory, reference memory, attention and executive functioning

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13
Q

What are some brain abnormalities in schizophrenia?

A

Enlarged cerebral ventricles, neuronal disorganization, accelerated loss of cortical grady matter during adolescence

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14
Q

What is the dopamine hypothesis of schizophrenia?

A

Overactivation of mesolimbic dopamine circuitry is thought to underlie positive symptoms of schizophrenia.

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15
Q

What is the dopamine hypothesis based on?

A

Antipsychotics block dopamine receptors, primarily D2 receptors

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16
Q

What is the revised dopamine hypothesis of schizophrenia?

A

Hypoactivation of mesocortical dopamine circuitry is thought to underlie negative and cognitive symptoms of schizophrenia

other dopamine circuits are thought to function normally

17
Q

What is the glutamate hypothesis of schizophrenia?

A

Mesolimbic dopamine neurons are tonically activated by glutamate neurons in the frontal cortex that activate GABA interneurons in the VTA

Hypofunction of NMDA receptors on GABA interneurons causes less activation, releasing the brake on mesolimbic dopamine neurons resulting in overactivity and psychotic symptoms

18
Q

What is the glutamate hypothesis based on?

A

NMDA receptor blockers (PCP, ketamine) produces schizophrenia like symptoms in humans

19
Q

What are the 2 classes of glutamate receptors?

A

Ionotropic: Ligand gated ion channels (NMDA, AMPA and Kainate)

mesotropic: G-protein couple receptors (mGluR)

20
Q

What is the NMDA receptor critical for?

A

Synaptic plasticity and has binding sites for many molecules and ions

21
Q

What is the excitotoxicity hypothesis of schizophrenia?

A

During brain development, excessive calcium influx through NMDA receptors causes the production of free radicals which cause excitotoxicity, neurodegeneration and abnormal brain development

22
Q

What are antipsychotics also known as?

A

Neuroleptics

23
Q

Name 6 typical antipsychotics

A 
chlorpromazine 
thioridazine
loxapine
perphenazine
haloperidol (Haldol) fluphenazine,
24
Q

Name 6 2nd generation or atypical antipsychotics

A 
clozapine (Clozaril)
olanzapine (Zyprexa)
quetiapine (Seroquel)
risperidone (Risperdal)
ziprasidone (Geodon), 
aripiprazole (Abilify),
25
Q

How do typical antipsychotics work?

A

Blocking D2 receptors

26
Q

How do 2nd generation or atypical antipsychotics work?

A

In addition to block D2 receptors, they also have antagonistic or inverse agonist properties at 5-HT2S receptors

27
Q

What are the extrapyramidal side effects of antipsychotic medications?

A

involuntary and repetitive movements such as tardive dyskinesia, due to blockade of D2 receptors in striatum

28
Q

What are the cholinergic side effects of antipsychotic medications?

A

Blurred vision, constipation, drowsiness and dry mouth due to M1 muscarinic receptor antagonism

29
Q

Explain why drowsiness and weight gain occurs with antipsychotics

A

H1 histamine receptor antagonism

30
Q

Explain why hypotension and dizziness occurs with antipsychotics

A

Due to alpha1 noradrenergic receptor antagonism

Psychopharmacology (17 decks)

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