Psychopharmacology Masserano Flashcards
Dopamine Theory of Psychoses
Due to excess dopaminergic activity in the brain
Cocaine, amphetamine, levodopa, can increase dopamine and cause psychosis
Mesolimbic pathway
hyperactivity = positive symptoms. Therapeutic D2 blockade
Mesocortical pathway
hypoactivity = negative symptoms. Influenced by 5-HT
Nigrostriatal pahtway
regulates motor movement. Side effects of dopamine blockade (pseudoparkinson)
Tuberoinfundibular pathway
inhibits prolactin release. Side effect of dopamine blockade
Schizophrenia Neurochemistry Theory: hyperdopaminergic
Increased dopamine in mesolimbic pathway causes positive symptoms. Antagonism of D2 receptors decreases positive symptoms
Schizophrenia Neurochemistry Theory: Hypodopaminergic
Less dopamine in mesocortical system causes negative symptoms. Antagonism of 5-HT2a in cortical areas increases DA release; this will control negative symptoms but cannot be used to treat schizophrenia alone.
SALSA
Sleep disturbance
Anhedonia
Low Self esteem
Appetite decreased
SIG E CAPS
Sleep decreased Interest decreased Guilt Energy decreased Concentration difficulties Appetite disturbance Psychomotor retardation Suicidal thoughts
Bipolar 1
mania and major depression
Bipolar II
hypomania and major depression
Cyclothymic
hypomania and mild to moderate depression
Dysthymic
Mild or moderate depression most of the time with no discrete episodes
Monoamine Theory of Depression
Depression due to lack of CNS 5-HT and NE.
Reserpine depletes amines and induces depression
Beta blockers with high lipid solubility may produce depression
Neurogenesis Theory of Depression
Stress-induced decreases in hippocampal neurogenesis are causal factor in precipitating depression
Bipolar manic episodes
1 week of profound mood disturbance with at lease 3 of the following symptoms: Grandiosity Diminished need for sleep Excessive talking or pressured speech Racing thoughts or flight of ideas Clear evidence of distractibility Increased level of goal-focused activity at home, work, or sexually Excessive pleasurable activities
Bipolar major depressive episode
Duration of 2 weeks with at least 5 or more symptoms
Lithium MOA
Attenuates the activity of secondary messengers and depletes IP3 and DAG
Lithium BBW
Lithium toxicity occurs at close to therapeutic levels so it requires very close serum monitoring
