Schizophrenia

Question 1

What are the positive symptoms?

Answer 1

Disorders of thought/disorganised behaviour
Hallucinations
Paranoia

Question 2

What are the negative symptoms?

Answer 2

Blunted emotions
Social withdrawal
Loss of energy
Cognitive impairment

Question 3

What is schizophrenia?

Answer 3

Disease of the process of thought + perception

Question 4

What are the contributing factors?

Answer 4

Nutrition of mother when in utero
Obstetric complications
Childhood trauma
Social connections
Infection
Drug misuse

Question 5

What was the 1st anti-psychotic?

Answer 5

Chlorpromazine

Question 6

What is suggested that the positive symptoms are due to?

Answer 6

Excess dopamine

Question 7

Which receptor are the most important?

Answer 7

D2
D3 = negative symptoms

Question 8

Why do you often get side effects with the medication?

Answer 8

Because they can’t specifically target D2

Question 9

What is the 1st pathway targeted by antipsychotics?

Answer 9

Mesolimbic pathway

Question 10

What is the location of the mesolimbic pathway?

Answer 10

Projects from ventral tegmental area (VTA)

Question 11

What happens if there is hyperactivity in the mesolimbic pathway?

Answer 11

Positive symptoms - eg. hallucinations

Question 12

What happens when you block the mesolimbic pathway?

Answer 12

Treats positive symptoms
BUT can blunt pleasure

Question 13

What are the side effects of blocking the mesolimbic pathway?

Answer 13

Lack motivation
Lack of interest
Lack of joy

Question 14

What is the 2nd pathway targeted by antipsychotics?

Answer 14

Mesocortical pathway

Question 15

What is the location of the mesocortical pathway?

Answer 15

Pre-frontal area
Projects from VTA

Question 16

What happens if there are hyperactivity in the mesocortical pathway?

Answer 16

Negative symptoms

Question 17

What happens if you block the mesocortical pathway?

Answer 17

May make negative symptoms + cognition worse

Question 18

What is the 3rd pathway targeted by antipsychotics?

Answer 18

Nigrostriatal pathway

Question 19

What is the location of the nigrostriatal pathway?

Answer 19

Projects from substantia nigra

Question 20

What happens if there is hyperactivity in the nigrostriatal pathway?

Answer 20

Tics
Dyskinesia

Question 21

What happens if you block the nigrostriatal pathway?

Answer 21

Dystonia (stiffness)
This is called an EPSEs

Question 22

What is an EPSE?

Answer 22

Extra pyramidal side effect

Question 23

How does tardive dyskinesia happen?

Answer 23

Chronic blocking of D2 in nigrostriatal pathway
= facial + tongue movements
= limb movements

Question 24

What is the 4th pathway targeted by antipsychotics?

Answer 24

Tuberoinfundibular pathway

Question 25

What is the location of the tuberoinfundibular pathway?

Answer 25

Projects from hypothalamus

Question 26

What happens if you block the tuberoinfundibular?

Answer 26

Leads to hyperprolactinemia

Question 27

What will the ideal antipsychotic do?

Answer 27

Decrease dopamine in mesolimbic to treat positive + Increase dopamine in mesocortical to treat negative Whilst also Leaving dopamine tone unchanged in both nigrostriatal + tuberoinfundibular

Question 28

What are the side effects of M1 cholinergic receptors?

Answer 28

Dry mouth Blurred vision Constipation Cognitive blunting