Schizophrenia Flashcards
What is Schizophrenia
debilitating psychotic illness, difficulty perceiving reality
Most well-known symptoms of schizophrenia
Hallucinations - auditory - visual Delusions - paranoia - grandiose
Positive symptoms definition, examples of schizophrenia
behaviours not normal in healthy people
- disorganized speech
- disorganized flow, the content of thoughts
- an absence of goal-oriented behaviours
- nonsensical rhymes, neologism
Negative symptoms, def., examples
loss of normal behaviours found in healthy people
- social withdrawal
- flattened mood
- cognitive impairments, memory, function
- usually comorbidities
What % of the worlds population is affected?
1%
What factors contribute to risk?
Genetics
Environment
Which pair would imply more heritability, fraternal or identical twins?
Identical twins, 50-80% concordance
When is it usually onset?
early adulthood
men, 18-20
women, 24-30
Environmental factors
Maternal infection maternal starvation obstetric complications cat feces, glondii low socioeconomic status urbanicity drug abuse physical/psychological trauma, childhood
historical treatments of schizophrenia
institutionalized induced seizure induced hypoglycemia (low blood sugar levels) frontal lobotomy sedatives, barbiturates psychotherapy
first antipsychotic?
chlorpromazine
MOA of chlorpromazine
D2 anatagonist
Screening method for drugs developed right after chlorpromazine
motor impairing drugs, if they did not, they were not pursued
Traits of typical APS
motor impairment
D2 antagonists
Traits of atypical APS
do not act as much on D2, but on 5HT
could have dual action
Traits of atypical APS
do not act as much on D2, but on 5HT
could have dual action
rational drug development, schizophrenia
drugs that act on D2, 5HT
Name typical APS
Chlorpromazine
Haloperidol
Name atypical APS
clozapine
risperidone
olanzapine
Why do typical APS impair motor function?
blocking D2, dopamine facilitates movement
What is anhedonia
reduced or inability to feel pleasure, especially from things you would normally enjoy
Reproductive hormone effects
D2 in the pituitary gland prolactin increase men and women lactate men, breast development women, prevents menstruation
What is the most effective treatment for schizophrenia currently?
clozapine, atypical
a rare side effect of clozapine?
loss of white blood cells
MOA of clozapine
antagonist fo 5HT,
what drug led to rational drug development and what was it?
clozapine
drugs that block D2 or 5HT
What are the other atypical APS, that are usually prescribed first?
risperidone
aripiprazole
(olanzapine)
side effects of atypical
metabolic syndrome
weight gain
type 2 diabetes
risks of heart disease
Efficacy of APS
can treat positive symptoms, limited for negative symptoms
what drug is the exception when it comes to treating negative symptoms?
clozapine
what fraction of patients arent helped by APS
1/3
“treatment resistant”
showing no results after trying 2-3 different APS
Dual action APS
risperidone
olanzapine
the ratio of men to women affected?
1.4:1
How much does genetics play a role?
80%
avolition
decreased motivation, no motivation
what drug effects were they looking for prior to to making chlorpromazine
reduced antihistamine enhanced sedative properties
anti-emetic properties
anti-nausea and vomiting
clozapine and catalepsy
catalepsy, involuntary movement
clozapine was effective without inducing catalespy
1st generation APS, typical side effects
motor-impairment/parkinsons/extrapyramidal
hormonal effects
tardive dyskinesia (involuntary neurological movement)
new ideas about schizophrenia
not one gene changed in every patient umbrella diagnosis thoughts: - rare mutation - several risk genes
