Schizophrenia and antipsychotic drugs

Question 1

What is schizophrenia?

Answer 1

‘Divided mind’.

Severe psychiatric disorder, distortion of thoughts and perception

Question 2

What are the positive symptoms of schizophrenia (TYPE I)?

Answer 2

Presence of abnormal throughts and behaviours

- delusions, hallucinations, disorganised speech, catatonic behaviour

Question 3

What are the negative symptoms of schizophrenia (TYPE II)?

Answer 3

Absence of normal behaviours

- decreased expression of emotion, social withdrawal

Question 4

What is the dopamine hypothesis of schizophrenia?

Answer 4

Dopamine hyperactivity underlies schizophrenia

Question 5

What was the first antipsychotic?

Answer 5

Chlorpromazine

Question 6

What are the first generation neuroeleptics (typical neuroleptics)?

Answer 6

Phenothiazines e.g. Chlorpromazine, fluphenazine Butyrophenones e.g. haloperidol, droperidol
Thioxanthines e.g. Flupenthixol, clopenthixol

These block a variety of receptor sites: dopamine, ACh, histamine, noradrenaline, 5-HT

Question 7

What are the second generation neuroleptics (atypical)?

Answer 7

Sulpiride, amisulpride
Selective dopamine receptor antagonists: clozapine, olanzapine
Multi-acting receptor targeted agents (MARTAs): risperidone, zotepine, sertindole
Serotonin-dopamine antagonists: quetiapine, aripiprazole

Question 8

What drug treatment would treat positive symptoms?

Answer 8

Typical neuroleptics

Question 9

What drug treatment would treat negatives symptoms?

Answer 9

Atypical neuroleptics

Question 10

What side effects are associated with neuroleptic drugs (dopaminergic)?

Answer 10

Increased prolactin release - breast swelling, pain and lactation
Motor disturbances

Question 11

What are the side effects of neuroleptic drugs (non-dopinamergic)

Answer 11

• Antimuscarinic effects: dry mouth, constipation, visual disturbances
• Postural hypotension due to alpha adrenoreceptor block
• Sedation due to histamine receptor block