Schizophrenia Flashcards
positive symptoms
delusions, hallucinations
negative symptoms
thought disorder, language disorder, flat/incongruent affect
diagnostic criteria
2 of (delusions, hallucinations, disorganized speech, grossly disorganized/catatonic behavior, negative sx) for at least one month
social/occupational dysfunction
no prominent mood d/o
not due to meds, other condition, or substance use
not part of autism or PDD
normal age of onset
18-25. earlier in men than women
prevalence
1% or world population
genetic inheritance
non-mendelian. polygenic disorder
non-genetic factors
viruses, malnutrition in utero, birth complications`
dopamine theory
DA hyperactivity in mesolimbic (VTA –> NA) system –> positive sx
DA hypoactivity in mesocortical (VTA -> PFC –> cognitive processing; SNc –> basal ganglia –> motor control) system –> negative sx
glutamate model
glutamatergic hypoactivity –> schizophrenia
chronic NMDA block –> persistent elevation of DA release in nucleus accumbens (mesolimbic) and decreased DA release in PFC (mesocortical)
common side effect of all antipsychotics
Parkinson symptoms (DA blockers)
which dopamine receptor is most sensitive to antipsychotics?
DR2
treatment for Parkinson-like side effects of antipsychotics
anticholinergics (cogentin, benadryl)
phenothiazines
typical. chlorpromazine (thorazine), perphenazine (trilafon), fluphenazine (prolixin)
Thioxanthines
Typical. Thiothixine
Butyrophenones
Typical. Haloperidol (Haldol)
pharmacokinetics of typical antipsychotics
highly lipophilic, >24h half life, no tolerance
Side effects of typical antipsychotics
EPS (basal ganglia), tardive dyskinesia
Clozapine
atypical. less parkinsonism than typicals. blocks 5HT, norepinephrine, Ach, DA receptors. Most effective neuroleptic. Potential for agranulocytosis –> limited use
5HT-2 blockers
atypical. Risperidone, olanzapine, quetiapine, asenapine, ziprasidone
Mixed DA agonist/antagonist
Aripiprazole
Atypical antipsychotics side effects
enhanced appetite –> weight gain, hypercholesterolemia, diabetes
