Schizophrenia Flashcards
What are some examples of positive symptoms of schizophrenia?
Hallucinations
Delusions
Grandeur - increased self esteem
Hyperactivity
What are some examples of negative symptoms of schizophrenia?
Hygiene
Social withdrawal
Reduced quality of life
Lethargy
What are some examples of 1st generation antipsychotics (typicals)?
Haloperidol
Chlorpromazine
Flupenthixol depot
What are some examples of second generation antipsychotics (atypical)?
Olanzapine
Clozapine
Quetiapine
Aripiprazole
Amisulpride
What is the 48h rule associated with clozapine?
If a dose is missed for >2 days, then the patient must be re-titrated again to avoid side effects
What specific side effects should you not ignore with clozapine?
Weight gain
Agranulocytosis
Constipation - can cause faecal impaction
What would you need to do if a patient is a smoker and is taking clozapine?
Smoking induced liver enzymes which metabolises clozapine, so a higher dose would be needed
At what stage of schizophrenia is clozapine given?
When 2 antipsychotics have not worked
Which atypical antipsychotic has the lowest risk of weight gain and sedation?
Aripiprazole
What are some examples of extrapyramidal side effects associated with typicals?
Tremor
Parkinsons
Tardive dyskinesia - involuntary movements of face/tongue/lips
Acute dystonia
What monitoring parameters are associated with all antpisychotics?
BMI
FBC
HbA1c
Prolactin levels
LFTs
Renal function
Lipid profile
Pulse/Bp
Which antipsychotic is most likely to cause diabetes?
Olanzapine (due to excessive weight gain)
Why is olanzapine taken at night?
Because it can induce sedation
Why is gynecomastia and galactorrhoea a common side effect for all antipsychotics?
Because antipsychotics work by inhibiting dopaminergic activity, and dopamine is known to inhibit prolactin.
When dopamine is inhibited, prolactin levels rise and can cause increased breast tissue in men (gynecomastia), and milk secretions (galactorrhoea)
Which 2 antipsychotics are known to be used as a water soluble short acting IM, and long acting depot IM?
Short acting - zuclopenthixol acetate
Long acting - zuclopenthixol decanoate
