Schizophrenia and Antipsychotic Drugs Flashcards
3 types of schizophrenia symtptoms
positive
negative
cognitive
positive Sch symtoms
hallucinations
delusions
agitation
disorganised thinking
negative sch symptoms
introversion
apathy
low self esteem
personal neglect
cognitive sch symtoms
poor memory, esp working memory
attention deficit
executive dysfunction
average age of sch onset in males and females
males - 18-25
females - 25-35
the DSM-5 criteria requires a patient to have how many of the following symptoms for sch diagnosis - delusions, hallucinations, disorganised speech, disorganised/catatonic behaviour, negative symtoms
2, 1 of which must be delusions, hallucinations, or disorganised speech
how long must sch symptoms occur before DSM5 diagnosis
6 months with at least 1 month active symptoms
3 patterns of sch lifetime evolution
simple
undulating
atypical
structural changes in sch
larger ventricles
smaller medial temporal lobe structures
grey matter loss
which part of the brain is hypoactive in schizophrenia
frontal lobe
how is frontal lobe function assessed
wisconsin card sorting test
what does the wisconsin card sorting test involve
pt asked to match cards withour being told rules for matching, rules for matching are changed throughout the test
do structural brain changes or symptoms occur first in sch
structural brain changes
what part of neurones are fewer in the cortices of sch pts and why
dendritic spines - excess pruning
how is sch linked to neurodevelopment
some forms of sch caused by brain circuit formation and maturation abnormalities
sch risk factors
pregnancy/birth complications
older father
immune system activation
cannabis
Repeated infections
Prenatal infection + incr cytokine levels in pregnancy
prodromal phase
period of sub clinical symptoms in the years prior to first psychosis episode
What signs of neuro inflammation are present in the brains of sch pts
Incr cytokine level
Incr peripheral inflammatory markers
Immune cell migration to brain
Activated microglia
Why is oligodendrocyte density decreased in sch
Inflammation and immune activation
Different expression of molecules regulating myelination
Is synchronicity in the default brain network increased or decreased in sch pts and their relatives
Increased
Which neural circuits are effected by sch and how are they effected
Mesolimbic - hyperactive
Mesocortical - hypoactive
Incr synchronicity in DMN
Which type of dopamine receptors are targeted by sch drug
D2 like
Which type of antipsychotics can help cognitive symtoms
Atypical antipsychotics
Are chlorpromazine, thioridazine, fluphenazine, haloperidol, and flupenthixol typical or atypical antipsychotics
Typical
Atypical antipsychotic examples
Risperidone
Olanzapine
Clozapine
Quetiapine
Paliperidone
Aripiprazole
Are atypical or typical antipsychotics used first
Atypical
Which drug is used for treatment resistant sch
Clozapine
Why are adverse effects common with antipsychotics
Not fully specific for dopamine receptors so affect other targets
Antipsychotic drug adverse effects
Extrapyramidal effects
Prolactin rise
Weight gain
Dyslipidaemia
Type 2 diabetes
Anticholinergic effects
Postural hypotension
Neuroleptic malignant syndrome
Extrapyramidal effects
Acute Dystonia
Parkinsonism
Tardive dyskinesia
Which system is most commonly effected by atypical antipsychotic adverse effects
Metabolic
Which system is most commonly effected by typical antipsychotic adverse effects
Extrapyramidal
Neuroleptic malignant syndrome symtoms
Hyperpyrexia
Muscle rigidity
Tremor
Confusion
Autonomic instability
Tardive dyskinesia
Involuntary movements of the lips, jaw, and face, and limbs, grimacing, chewing, and tongue thrusting
Major risk of clozapine
Agranulocytosis
Non pharmacological sch treatments
CBT
cognitive remediation
Family therapy
