P21: Neuroleptics & Schizophrenia Flashcards

1
Q

Generally schizophrenia is a disorder of?

A

Thought and emotion

not split-personality

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2
Q

What are positive schizophrenia symptoms?

A
  • Delusions & hallucinations (especially auditory)

- Bizarre behaviour

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3
Q

What are negative schizophrenia symptoms?

A
  • Social withdrawal
  • Avolition (no motivation)
  • Poverty of speech
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4
Q

What are cognitive schizophrenia symptoms?

A
  • Poor concentration
  • Disorientation
  • Difficulties in abstract thought and memory
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5
Q

What is the single greatest risk factor for schizophrenia?

A

Having an affected first degree relative

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6
Q

Which sex is more likely to have schizophrenia?

A

Males being roughly 40% more likely

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7
Q

What areas in the brain have a smaller volume in schizophrenics?

A
  • Amygdala
  • Thalamus
  • Nucleus accumbens
  • Intracranial space
  • Hippocampus (antipsychotic drug treat)
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8
Q

What areas in the brain have a larger volume in schizophrenics?

A

Larger pallidum and ventricular volumes

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9
Q

What evidence supports the Dopamine Theory of Schizophrenia?

A
  • All anti-psychotic drugs are dopamine receptor antagonists

- Amphetamine and cocaine increase DA release and induce schizophrenic - like syndrome

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10
Q

What does the Dopamine Theory of Schizophrenia suggest?

A

That release of excessive dopamine release causes schizophrenia

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11
Q

What does the nigrostriatal dopamine pathway control?

A

Motor control and co-ordination

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12
Q

What does the Mesolimbic-mesocortical dopamine pathway control?

A
  • Mood
  • Cognition
  • Thought
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13
Q

What does the Tuberoinfundibular dopamine pathway control?

A

Control of prolactin release

prolactin is used for breast and milk development

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14
Q

Post-mortem, Schizophrenic brains have significantly lower expression of which receptors?

A

Glutamate receptors

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15
Q

What are drugs like phencyclidine and ketamine?

A
  • Glutamate-blocking drugs

- Mimic schizophrenic symptoms and cause cognitive problems

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16
Q

What does glutamate modulate?

A

Dopamine activity

17
Q

What do neuroleptics treat?

A

Schizophrenia

18
Q

Which schizophrenic symptoms do neuroleptics treat best?

A

More effective at treating positive symptoms

19
Q

What is Chlorpromazine?

A
  • Dopamine D2 receptor antagonist (also D1,3,5)

- Most successful

20
Q

What are the side effects of Chlorpromazine?

A
  • Extrapyramidal motor effects
  • Impotence
  • Anxiety
21
Q

What is Haloperidol?

A
  • Binds preferentially to D2 and α1 receptors at low dose and 5-HT2 receptors at higher doses
  • Most commonly used
22
Q

What are the side effects of Haloperidol?

A
  • Extrapyramidal motor effects
  • Impotence
  • Anxiety
23
Q

What is Clozapine?

A
  • Atypical anti-psychotic, first of its class

- Dopamine D2 receptor antagonist, with high affinity for D4 receptors

24
Q

What are the side effects of Clozapine?

A
  • Extrapyramidal motor effects
  • Agranulocytosis – loss of neutrophils and immunosuppression
  • impotence
25
Q

What is Tardive Dyskinesias?

A
  • Major side effect of anti-psychotic medications

- Characterised by involuntary, repetitive writhing movements of face and limbs

26
Q

How is Tardive Dyskinesias caused?

A
  • Thought to be due to the development of dopamine hypersensitivity in the nigrostriatal pathway
  • Resulting change in basal ganglia function