Schizophrenia Flashcards
How is schizophrenia classified?
psychiatric disorder characterized by positive symptoms (hallucinations, delusions), negative symptoms (apathy, lack of emotion), and cognitive deficits (impaired memory and attention).
positive symptoms of schizophrenia
Hallucinations, delusions, disorganized speech, and bizarre behavior (caused by dopamine hyperactivity in the mesolimbic pathway).
negative symptoms of schizophrenia
Reduced emotional expression, lack of motivation, social withdrawal, anhedonia (caused by dopamine hypoactivity in the mesocortical pathway).
What are the cognitive symptoms of schizophrenia?
Impaired attention, working memory deficits, and difficulty in problem-solving.
How is schizophrenia diagnosed?
Clinical diagnosis based on DSM-5/ICD-10 criteria, requiring at least two symptoms (one must be hallucinations, delusions, or disorganized speech) present for at least 1 month. No definitive lab test.
What imaging or tests might be done to rule out other conditions?
MRI/CT scans (to rule out brain abnormalities), drug screening (to exclude substance-induced psychosis).
What is the first-line treatment for schizophrenia?
Atypical (second-generation) antipsychotics, such as:
Risperidone
Olanzapine
Aripiprazole
Quetiapine
These have fewer extrapyramidal side effects (EPS) than typical antipsychotics.
What is used if first-line antipsychotics fail?
Clozapine (used for treatment-resistant schizophrenia but requires monitoring due to risk of agranulocytosis).
What are the adverse effects of typical (first-generation) antipsychotics?
Extrapyramidal side effects (EPS) – dystonia, akathisia, tardive dyskinesia
Neuroleptic Malignant Syndrome (NMS) – fever, muscle rigidity, altered mental status
Hyperprolactinemia – gynecomastia, menstrual irregularities
What are the adverse effects of atypical (second-generation) antipsychotics?
Metabolic syndrome – weight gain, diabetes, hyperlipidemia
Sedation & hypotension
Agranulocytosis (Clozapine only) – requires regular blood monitoring
What does the dopamine hypothesis state?
Schizophrenia is caused by hyperactivity of dopamine in the mesolimbic pathway (causing positive symptoms) and hypoactivity in the mesocortical pathway (causing negative symptoms).
How do amphetamines support the dopamine hypothesis?
Amphetamines increase dopamine, leading to hallucinations and delusions (similar to schizophrenia positive symptoms).
Chronic amphetamine use can cause “amphetamine psychosis.”
What happens when amphetamines are stopped after regular use?
Users experience fatigue, anxiety, and depression, leading to psychological dependence.
Is there a physical withdrawal syndrome for amphetamines?
No physical withdrawal syndrome is known, but psychological dependence is common.
