Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Drugs And The Brain > psychosis > Flashcards

psychosis Flashcards

1
Q

main 4 symptoms of psychosis

A

delusions, disordered thoughts, hallucinations and catatonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what causes schizophrenia

A

schizophrenia
bipolar disorder
illegal drugs
prescription drugs
PTSD
sleep deprivation
caffeine intoxication
Alzheimer’s disease

-part of other conditions- can have causes that are not directly related to an illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

normal experience with first episode of psychosis

A

First episode usually unexpected

cannot usually be immediately diagnosed with particular causal disorder

definitive diagnosis may come later

may be designated as having experienced ‘brief psychotic episode’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is a ‘brief psychotic episode?

A

period of psychosis not caused by a mental health disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are psychotic episodes frequently predicted by

A

prodromal phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is predromal phase? How long does it last?

A

changes in behaviour: irritability, difficulty concentrating, memory problems, anxiety, depression

can last months to years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

why may there be a delay in treatment when acute phase begins?

A

person suffering doesn’t recognise they are ill? Friends/ relatives do not understand what’s happening?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the effect of delayed treatment

A

worse outcomes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what can help a person receive speed intervention?

A

If person has experiences psychosis because of an underlying mental health condition, they may recognise prodromal symptoms and receive speed intervention before their next episode

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

three types of symptoms of schizophrenia

A

cognitive, positive and negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

positive symptoms of schizophrenia

A

hallucinations, delusions, disorganised speech, disorganised behaviour or catatonia

symptoms that a person with schizophrenia has that a normal individual does not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

negative symptoms of schizophrenia

A

loss of emotional response, anhedonia and apathy

symptoms that a person with schizophrenia lacks, that a normal person has

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

requirements for a schizophrenia diagnosis

A

two positive symptoms, or a positive and negative symptoms

must impact significantly

continuous signs of disturbance in behaviour for at least 6 months

not explained by something else

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

schizoaffective disorder

A

meets the criteria for schizophrenia and a major mood episode (mania or depression)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

three types of schizoaffective disorder

A

bipolar type, depressive type and mixed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

bipolar type schizoaffective disorder

A

manic and depressive episodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

depressive type schizoaffective disorder

A

depressive only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

mixed schizoaffective disorder

A

manic and depressed simultaneously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

epidemiology of schizophrenia

A

Around 1% of the population

Males 1.4x female (more frequent in males)

Strikes at an early age
Males: late teens
Females: late twenties
second female peak around the age of menopause

Highly disabling
no cure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

suicide and schizophrenia

A

Much higher rate of suicide in schizophrenia than depression

5% of those suffering will take their own life

(double the rate of people with depression, while 10-15% of people with bipolar disorder type 1 commit suicide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

obesity and antipsychotics

A

Many antipsychotics can produce significant increases in BMI
-likely due to actions at H1 and 5HT receptors. Because obesity is associated with T2DM,

increased BMI is likely to be a major reason why the risk of diabetes is higher in people on antipsychotic drugs.

the negative symptoms of schizophrenia and the sedative effects of antipsychotics may also contribute to weight gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

antipsychotics and insulin resistance

A

can induce insulin-resistance independent of their effects on BMI:
this effect can occur with drugs that do not produce marked changes in appetite.

Antipsychotics are thought to cause insulin resistance by inhibiting a component of the insulin signalling cascade, Akt,

and by decreasing the phosphorylation of one of the targets of the insulin receptor kinase activity, insulin receptor substrate 1 (IRS-1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Antipsychotics and beta cells

A

direct effect on beta cells

can cause pancreatic beta cell dysfunction in several ways

acting on muscarinic dopamine, adrenergic and serotonergic receptors they can decrease insulin secretion

may also decrease cellular concentrations of ATP which would also decrease insulin secretion

may damage beta cells and induce apoptosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

mental health act 1983

A

allows for compulsory hospitalisation and treatments

gives power to medical professionals, social workers and the police

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
section 2 mental health act
28 day assessment and treatment order
26
section 2 mental health act
28 day assessment and treatment order
27
section 3 mental health act
6 month treatment order can be renewed usually have a pre-diagnosed mental health disorder that has worsened, therefore doctors are sure that keeping them for an extended time is of benefit
28
sectioning
approved mental health professional or nearest relative must be seen by two doctors -one must be a psychiatrist -one has to know the patient and an approved mental health professional cannot refuse treatment (except ECT)
29
genetic factors of schizophrenia
1% in general population 8-10% if near relative affected 50% in twin studies (concordance rate) --Probably influence of many “tendency” genes, which may have a small impact individually (unlikely to be due to a single schizophrenia gene). eg. DISC1 – disrupted in schizophrenia 1 --Many of these tendency genes may require an environmental impact too
30
gene disrupted in schizophrenia 1
DISC 1
31
Environmental factors
winter birth substance abuse: cannabis, amphetamine
32
winter birth as an environmental for schizophrenia?
maternal exposure to viruses? controversial risk factor, many think it is a myth
33
amphetamine as an environmental factor for schizophrenia
causes psychosis can worsen the psychosis of someone who already have schizophrenia, or cause them to have a relapse
34
cannabis as an environmental factor of schizophrenia
heavy cannabis use can increase the risk of development about schizophrenia
35
why is it controversial that substance abuse may cause schizophrenia?
cause or effect? schizophrenics have a high risk for substance abuse
36
what does AKT1 code for?
kinase that inactivates enzyme glycogen synthase kinase involved in signalling via dopamine D2 receptors
37
example that genetic factors may require some influence of the environment
increased risk of schizophrenia in those homozygous for mutant ATK 1 when they use cannabis everyday, but not if they used cannabis at week ends or less, or never used cannabis
38
social factors influencing schizophrenia
difficult childhood conditions: -discrimination -dysfunctional families -abuse/ trauma epigenetic changes?
39
evidence schizophrenia may be a neurodevelopmental disorder
Age of onset (teenage/early adult) -around time where the brain is changing quite a lot Structural differences in the brain between schizophrenic and healthy individuals
40
evidence that schizophrenia is a neurodegenerative disorder
Progression of disease in many cases, particularly true if it is not treated early Reductions in brain volume Excitotoxicity? could be that glutamate is one of the major factors
41
T gondii
Risk factor suggested for schizophrenia and bipolar Estimated that up to 30% of the world’s population is infected with T gondii Once infected, impossible to get rid of Migrates to tissues (brain) , where it forms cysts Known to manipulate the behaviour of rodents to increase their chances of being eaten by cats (a necessary part of the parasite’s life cycle) Has been suggested that it may also be able to influence human behaviour
42
original form of dopamine hypothesis of schizophrenia
due to hyperactivity of the mesolimbic pathway (VTA to ventral striatum) unlikely to describe the root cause of schizophrenia but may be a 'final common pathway'
43
what is a final common pathway
system on which several different causal factors converge on to produce the symptoms of a disease
44
evidence for the dopamine hypothesis
reserpine depletes dopamine, leads to improvement in positive symptoms -hallucinations and delusions lessen amphetamine releases dopamine, amphetamine can cause psychosis L-DOPA and dopamine agonists can cause psychosis if given at high doses altered dopaminergic activity (hyperactivity) in certain brain areas may play a role in schizophrenia
45
D1 like receptors
D1, D5
46
D2 like receptors
D2, D3, D4
47
correlation of therapeutic concentration of antipsychotics with the concentration needed to occupy 75% of D2 receptors
almost 1:1 relationship indicates that activity at D2 receptors is important for antipsychotic activity
48
increased dopamine transmission in mesolimbic pathway
mesolimbic pathway involved in emotion, fear and motivation important in positive symptoms
49
suggested importance of mesocortical pathway in schizophrenia
Decreased dopaminergic transmission in mesocortical pathway, important in negative symptoms
50
dopaminergic pathways seen as being important in side effects
tuberhypophyseal (HT/Pituitary) - hormone release from the pituitary nigrostriatal - motor control. important in Parkinson's disease
51
modern view of dopaminergic pathways
excess of dopaminergic activity in the nigrostriatal pathway going to the associative pathway -explains positive symptoms normal ore reduced DA activity in the mesolimbic pathway to ventral striatum -cause of negative symptoms?
52
detail of associative striatum DA hypothesis of schizophrenia
Associative striatum (AS) involved in assigning salience to stimuli e.g. threat level Excess noise in AS dopaminergic signalling -increased salience assigned to unimportant stimuli -May lead to the positive symptoms Cognitive impairments -hypodopaminergic cortical function -possibly driven by striatal hyperdopaminergic signalling Negative symptoms -impaired reward based learning -not able to assign importance to things should be important –decreasing reward we get from those stimuli –possibly leading to apathy and anhedonia ?driven by striatal hyperdopaminergic signalling
53
involvement of other receptors in schizophrenia (not dopamine)
NMDA receptor dysfunction serotonin receptors muscarinic receptors
54
NMDA receptor dysfunction? in schizophrenia
glutamate dysfunction may be the root cause NMDA antagonists cause psychosis e.g. ketamine suggests that positive allosteric modulators of glutamate receptors could be a new therapeutic approach - AMPAkines?
55
Serotonin receptors and schizophrenia
LSD causes psychosis apathy and avolition in schizophrenia superficially similar to depression? probably not the root cause, but 5HT receptor activity seems to give a better therapeutic profile
56
muscarinic receptors and schizophrenia
mAChR antagonists worsen negative + cognitive symptoms Scopolamine (non-selective mAChR antagonist) can cause psychosis ? muscarinic agonists useful but mAChR antagonist activity gives better side effect profile -with antipsychtic drugs that don’t have activity at muscarinic receptors, you sometimes see very serious movement disorders as an unwanted effect- drugs that have muscarinic antagonistic activity seem to avoid this problem may be useful to develop subtype selective allosteric modulators -difficult to do as the sites of muscarinic receptors don’t differ much between receptor subtypes but may be possible to develop allosteric modulators of individual subtypes -allosteric site on muscarinic receptors is much less conserved so it may be a viable therapeutic approach
57
antipsychotics : dirty drugs
dopamine D2 antagonists/ partial agonists -actions at many different receptor types -lack of selectivity = side effects dirty nature may also give rise to therapeutic benefits e.g. actions at 5HTR
58
common side effects of antipsychotics
extrapyramidal effects (esp in older) galactorrhea cognitive impairment sedation weight gain anti-muscarinic effects
59
what are extrapyramidal effects? what causes them?
Movement disorders dystonia: involuntary muscle contraction and spasms tardive dyskinesia: face, body/ both make sudden irregular movements - can be permenant probably interfering with the function of D2 receptors in the motor striatum
60
what is galactorrhea? what causes it?
inappropriate milk production in women who haven't given birth tuberohypophyseal D2 receptors inhibit prolactin release. When these are inhibited it causes hyperprolactinemia
61
what causes cognitive impairment (antipsychotics)
D2 inhibition in cortex? effects at other receptors (anti-muscarinic effects probably produce cognitive impairment too
62
why do antipsychotics cause sedation?
Histamine H1 antagonism ?
63
why do antipsychotics cause weight gain?
H1 and 5HTR antagonism?
64
what are anti-muscarinic side effects?
dry mouth, blurred vision, memory problems (cog impairment), cardiac problems

Drugs And The Brain (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions