Lecture 3 - Mental Health

Question 1

What kind of neurotransmitters are there?

Answer 1

Monoamines
- Histamine
- Catecholamines
- Tryptamines
Amino acids
- Glutamic acid
- GABA
Acetylcholine

Question 2

What classes of mental health medicines are there?

Question 3

Antipsychotics are used for?

Answer 3

Schizophrenia
Acute mania
Psychotic depression
Nausea
Delirium
Calm disturbed patients
Stabilise mood
Severe anxiety

Question 4

Do antipsychotics cure schizophrenia?

Answer 4

No, only to treat the side effects.

Question 5

How do antipsychotics work?

Answer 5

Blocking the action of dopamine in the brain, Dopamine is neurotransmitter
Side effects are caused by blocking dopamine and other neurotransmitters in other parts of the body (adrenaline, histamine)

Question 6

What are the two groups of antipsychotics?

Answer 6

First generation (Typical) 
Second generation (Atypical) - Fewer side effects.

Question 7

What are first gen antipsychotics?

Answer 7

Effective at blocking dopamine
Also active at adrenaline and histamine receptors, producing unwanted side effects.
Side effects:
- Sedation
- Anticholinergic side effects (dry mouth, constipation, blurred vision, urine retention)
- Extrapyramidal side effects (EPSEs) (Akathisia, Dystonia, Tardive dyskinesia, parkinsonism)

Question 8

Second generation antipsychotics are?

Answer 8

As effective as first generation (typical) antipsychotics
Fewer ESPEs
Highly selective to D2 receptors
Also:
- Histaminergic (sedation)
- Serotonergic (weight gain)
- Muscarinic (Blurred vision, dry mouth, constipation, precipitation of glaucoma)
- Alpha-adrenergic (postural hypotension, sedation)

Question 9

What is clozapine?

Answer 9

Clozapine is a second generation antipsychotic which is used for treatment resistant schizophrenia and psychosis in Parkinson’s Disease.
Prescribed after trial of 2 antipsychotics (one of which is atypical)
Does not cause extrapyramidal side effects (EPSEs)
Clozapine is effective for both positive and negative symptoms:
- Positive (hallucinations, delusions, thought disorders, lack of insight, cognitive changes)
Negative (poverty of thought and speech, blunt affect, anhedonia or lack of pleasure, social withdrawal, lack of drive and interest.

Question 10

Neuroleptic Malignant Syndrome is?

Answer 10

Rare but potentially serious and fatal.