Neuroleptics [6] Flashcards
What’s the difference between positive and negative symptoms or schizophrenia & examples
Positive add effects (hallucinations)
Negative take away (blunted emotion)
2 historical physical treatments for schizophrenia
Straitjacket
Water baths with lids
3 historical biological treatments for schizophrenia
Insulin coma therapy
- induce hyperglycaemia to cause coma
ECV
- electric shock to temples
Lobotomy
- drilling into skull & introducing leucotome
What is the dopamine theory of schizophrenia
Hyperactive dopamine
What is the pharmacological evidence for the dopamine theory 1/3
Amphetamine - releases DA in brain. Can mimic positive symptoms
What is the pharmacological evidence for the dopamine theory 2/3
D2 agonists (apomorphine) - exacerbate symptoms in patients
What is the pharmacological evidence for the dopamine theory 3/3
DA antagonists - block DA release & control positive symptoms
What is the biochemical evidence for the dopamine theory
HVA (DA metabolite) conc in brain isn’t higher in schizo patients
There’s also 2x D2 receptors and 6x D4 receptors
What is the serotonin hypothesis of schizophrenia
5-HT is involved
Post mortem studies show altered 5-HT transmission in schizo patients
Phenothiazines are classical neuroleptics
Name 3 and where they are derived from
Chlorpromazine - aliphatic derivative
Fluphenazine - piperazine derivative
Thioridazine - piperidine derivative
What do phenothiazines do
Block neurotransmitter receptors
- side chain determines potency
Mechanism of neuroleptics
Block D2 receptors
Initially increase rate of production of DA in brain
Behavioural effects of neuroleptics
Apathy and decreased initiative
Aggression reduced
Explain antiemetic activity of neuroleptics
DA antagonist activity (DA agonist action on CTZ induces nausea)
DA antagonist related unwanted effects of neuroleptics
Tardive dyskinesia
Parkinson like symptoms
