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Biopsych IWS > Neurotransmitter dysfunction > Flashcards

Neurotransmitter dysfunction Flashcards

1
Q

What do Monoamines comprise of ? ( C + I)

A

3 Catecholamines
2 Indolamines

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2
Q

What are the 3 Catecholamines ( DAN)

A

Dopamine
Noradrenaline
Adrenaline

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3
Q

What are the 2 Indolamines ( S + M)

A

Serotonin
Melatonin

  • Histamine

See Diag P 54

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4
Q

What does monoamine system dysfunction refer to ? ( Stimulant abuse > Psychosis + ? )

A

Repeated psychostimulant drug abuse:

Paranoid Psychosis ( * Like Schizophrenia)

Seizures

Depression/ Anxiety/ Parkinsons like symptoms

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5
Q

Describe 3 Core Schizophrenia symptoms ? ( +ve, -ve, Cog.)

A
  • Psychotic ‘positive’ symptoms (episodic) Delusions, hallucinations, thought disorders
  • Deficit ‘negative’ symptoms (chronic)
    disturbances in: motivation, experience of pleasure, social interactions, spontaneous speech, mood expression
  • Cognitive impairment (chronic)
    intellectual, memory, executive function, attention
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5
Q

What are the 3 psychotic Positive symptoms?
( HED)

A
  • Hallucinations - usually auditory (single or multiple)
    Delusions (paranoid) - persecution, grandiosity,
  • external control, thoughts inserted or removed, mind read Thought disorder - (tangential, loosening associations)
  • Disorganised thinking and behaviour - trouble with simple tasks
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6
Q

What are the 4 main NT involves in Schizophrenia?
D- S-G -G

A
  • Dopamine (DA)
  • Serotonin (5-HT)
  • Glutamate
  • GABA
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7
Q

What is the dopamine Hypothesis of schizophrenia? (

A
  • Drugs which increase dopamine levels (in “nucleus accumbens”) produce positive psychotic symptoms

-**Amphetamine, cocaine, dopamine receptor agonists
- Drugs which block dopamine transmission alleviate some symptoms (dopamine ***antagonists)

  • 1950s Chlorpromazine (developed as antihistamine) reduced positive symptoms of schizophrenia - (blocks dopamine receptors)

-Dopamine neurotransmission is involved in psychosis
* see P 56

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8
Q

Is Meso- cortico- limbic dopamine system abnormal in schizophrenic ?

A

Yes

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9
Q

Explain the above meso-cortico-limbic system above ( up or down dopamine)

A

positive psychotic symptoms:due 2 INcreased Dopamine (mesolimbic dopamine)

The negative and cognitive symptoms due to DEcreased Dopamine in the PFC (mesocortical)

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10
Q

Explain Meso- limbic Dopamine System ( INV D2 receptors : +ve symptoms. Schizop.)

A

The nucleus accumbens directly influences output of the dorsal striatum (Caudate & Putamen) - weakens the ‘filter’

Increased NO. of dopamine D2 receptors (mesolimbic system) with schizophrenia

Enhanced dopamine neurotransmission at Dopamine D2 receptors > positive symptoms of schizop.

Ø Use a dopamine D2 receptor antagonist to prevent psychoses

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11
Q

First Generation Antipsychotic neuroleptics are ? ( Chlorpromazine + …)

A

Chlorpromazine, Haloperidol
- BLOCK dopamine D2 receptors : effective at reducing psychotic symptoms

Better binding to D2 receptors = better clinical potency

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12
Q

What is down side of Typical Antispsychotics above? ( No effect, relapse, Excarebate, Intolerant)

A

antagonise both Dopamine D1 / D2 receptors (and many other receptors!!)

  • no effect on NEG or COG symptoms - ineffective in 30 % patients
  • Exacerbate symptoms in some
  • 20 % relapse rate
  • 5-10% have intolerable side effects (due to many receptors involved) - cardiotoxicity
  • Extrapyramidal Side Effects (EPS)
  • Diag p58
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13
Q

What are the extrapyramidal effects of antipsychotics? ( Parkinson, Dystonias, Tardive Dyskinesia)

A

80% of D2 receptors need to be blocked - Ø80% of D2 receptors blocked also effect D1 receptors

Parkinson’s like symptoms (reduced dopamine transmission in Caudate Nucleus)

Acute dystonias (involuntary movements)
muscle spasms, protruding tongue

May cause development of Tardive Dyskinesia (20-40% over years) Debilitating movement disorder - involuntary movements: jaw/lips/limbs

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14
Q

New antipsychotics that are more selective for D2 receptors? ( SILPIRIDE)

A

Silpiride

  • BUT Still no effect on negative or cognitive symptoms…. Need to address prefrontal cortex deficits
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15
Q

What do and dont Dopamine antagonists do?

A
  • Reduction*of dopamine in PFC
  • Dopamine D2 antagonists : reduce +ve symptoms
    -Serotonin: mediate negative and cognitive symptoms
    -Glutamate antagonists produce psychosis

**Reduced function of GABA neurons in the prefrontal cortex in schiz.

16
Q

What are the 8 symptoms of Depression ? (DAR DRS Feelings)

A

Depressed mood
Reduced interest in pleasure
Sleep disorders :Loss of energy
Feelings of guilt or worthlessness
Decreased attention
Altered eating patterns
Recurrent thoughts of death *15 % suicide rate if left untreated

17
Q

What is the monoamine Hypothesis ? ( “monoamine oxidase inhibitor” to elevate mood in depressed)

A

effectiveness of “monoamine oxidase inhibitor” to elevate mood in depressed pats. indicated depletion of monoamines contributed to the pathology of depression

18
Q

Name some Monoamines?SND)

A

Serotonin Noradrenaline (norepinephrine) Dopamine

19
Q

Tryptophan and link to depression? ( low > depression)

A

Depletion of dietary tryptophan produces symptoms of depression

20
Q

What are the 4 areas of the brain associated with Depression? (VAP Hippo Nuc)

A

PFC
Hippocampus
Nucleus accumbent
VTA
Amygdala

21
Q

What are some meds or actions to enhance Monoamine NT? ( anti-depressants: “monoamine oxidase inhibitor” - block

A
  • First Generation Anti-depressants
  • Tricyclic Antidepressants (TCAs)
  • Block re-uptake of all monoamines
  • Monoamine Oxidase Inhibitors
  • Block the metabolism of active monoamines

Diag p63-67

22
Q

Side effects of Tricyclic Antidepressants ?

A

Amitryptyline!!!
Side Effects:
(sympathetic/antimuscarinic)
Dry mouth, impaired vision, increased heart rate, difficult to pee
Memory and learning impairments (antihistamine)
Sedation
(blocks alpha 1 adrenoceptors - periphery)
Postural hypotension (low blood pressure on standing)
CARDIOTOXIC (blocks ability for heart to pump) 15 % depressed patients suicide - 25% by TCA overdose

22
Q

What are monoamine Oxidase Inhibitors? ( PPIT)

A

Phenelzine, pargyline, isocarboxazid, tranylcypromine : drugs block breakdown of all monoamines

23
Q

What are side effects of above? ( Tremors, excitement, insomnia, hypertension, headaches, food / drug interaction: avoid cheese, yeast, redwine

A

Tremors, excitement, insomnia (CNS overstimulation:convulsions) Food & drug interactions

Foods to avoid: Cheese/Concentrated yeast products/red wine that contain Tyramine Hypertension - headaches or intracranial haemorrhage Cardiotoxic (less than TCA’s)

24
Q

(SSRI’s) Selective Re-uptake Inhibitors Second Generation Antidepressants: their role? reuptake of serotonin and ? )

A

These focus on the re-uptake of serotonin or noradrenaline or both (Reduced Dopamine is not a major problem in depression)

Selective Serotonin Reuptake Inhibitors (SSRIs)
Noradrenaline Reuptake Inhibitors (NRIs) Serotonin and Noradrenaline Reuptake Inhibitors (SNRIs)

p 69

Biopsych IWS (11 decks)

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