Schizophrenia and psychotic disorders Flashcards
Environmental risk factors for developing schizophrenia
Urban living
Being a migrant
Winter/spring birth
Male:female incidence of schizophrenia
1.4:1
Point prevalence of schizophrenia
4.6/1000
Lifetime risk of schizophrenia
0.7%
Differences in schizophrenia epidemiology in developing countries
Lower rates overall
Higher comparative rates of catatonia
Lower comparative rates of hebephrenic schizophrenia
Percentage of patients with schizophrenia who have catatonia in developed countries
1%
Percentage of patients with schizophrenia who have catatonia in developing countries
10%
Percentage of patients with schizophrenia who have hebephrenia in developed countries
13%
Percentage of patients with schizophrenia who have hebephrenia in developing countries
4%
Percentage of apparently healthy people who report experiencing hallucinations
4.2%
Percentage of apparently people who report hearing voices saying ‘quite a few words’ when there was nobody around to account for it
0.7%
Average age of onset of delusional disorders
39
OR of schizophrenia with associated cannabis use
2.1
Figures who identified that patients with schizophrenia in high expressed emotion families were more likely to experience a relapse
Brown and Rutter
Risk of relapse within a year for patients with schizophrenia in high expressed emotion families without family therapy
64%
Risk of relapse within a year for patients with schizophrenia in high expressed emotion families after family therapy
24%
Three forms of social skills training for patients with schizohprenia
Basic model
Problem solving model
Cognitive remediation model
Description of the basic model of social skills training
Complex social repertoires are broken down into smaller steps, learned, practiced, and then applied to natural settings
Description of the social problem solving model of social skills training
Suggests that deficits in information processing are the cause of deficits in social skills
Aims to improve impairments in information processing
Targets medication and symptom management, recreation, basic conversation, and self care
Description of the cognitive remediation model of social skills training
Targets fundamental cognitive skills such as attention and planning
Suggests that improvements in fundamental skills will transfer to more complex processes
Percentage of patients with a first episode of psychosis who relapse within a year despite antipsychotic treatment
27%
Percentage of patients with a first episode of psychosis who relapse within a year with placebo treatment
61%
Percentage of all patients with psychosis who relapse within one year despite antipsychotic treatment
40%
Percentage of patients with psychosis who live in a stressful situation who relapse within one year despite antipsychotic treatment
62%
Lifetime suicide risk among patients with schizophrenia
5.6%
Subtypes of schizophrenia with the best prognosis
Catatonic
Paranoid
Subtype of schizophrenia with the worse prognosis
Hebephrenic
Positive prognostic factors in schizophrenia
Late onset
Clear precipitating factors
Acute onset
Good premorbid functioning
Affective symptoms
Being married
Family history of affective disorders
Positive symptoms only
Good initial treatment response
Female sex
Most important positive prognostic factor in schizophrenia
Good initial treatment response
Poor prognostic factors in schizophrenia
Early onset
Insidious onset
No clear precipitating factors
Social withdrawal
Being single, divorced, or widowed
Poor social support
High expressed emotion families
Negative symptoms
Poor treatment compliance
No remisson in 3 years
Many relapses
Perinatal trauma history
History of violence
Best predictors of a poor prognosis following a psychotic episode
Stressful life events
High expressed emotion families
Non-compliance with treatment
Drug which shows a moderate to large improvement over first generation antipsychotics in studies
Clozapine
Drugs which show a small to moderate improvement over first generation antipsychotics in studies
Olanzapine
Risperidone
Near maximal effective dose for aripiprazole
10mg/day
Near maximal effective dose for haloperidol
3.3-10mg/day
Near maximal effective dose for clozapine
> 400mg/day
Near maximal effective dose for olanzapine
> 16mg/day
Near maximal effective dose for risperidone
4mg/day
Findings in CATIE trial for staying with the same medication or switching when patients require a treatment review
Patients who stayed on the same medication did better, especially for olanzapine
Description of primary negative symptoms of schizophrenia
Negative symptoms that are intrinsic to schizophrenia
Description of secondary negative symptoms of schizophrenia
Negative symptoms that occur as a result of positive symptoms, treatment side effects, environmental deprivation etc.
Six features of deficit schizophrenia
Restricted affect
Diminished emotional range
Poverty of speech
Curbing of interest
Diminished sense of purpose
Diminished social drive
Number of features which must be present for a diagnosis of deficit schizophrenia
Two
Best studied second generation antipsychotic for negative symptoms
Amisulpride
Partial agonist at the glycine modulatory site of the glutamatergic NMDA receptor which has been investigated as an add on treatment for negative symptoms in schizophrenia
D-cycloserine
Antipsychotic shown to decrease suicidality among patients with schizophrenia better than olanzapine
Clozapine
First line treatment for patients with newly diagnosed schizophrenia
Oral atypical antipsychotic
Number of antipsychotics which should be tried at an adequate dose before trying clozapine
Two, with at least one atypical
Percentage of patients with schizophrenia who will have a relapse of a psychotic episode within a year despite treatment
20%
Percentage of patients with schizophrenia who will have a relapse of a psychotic episode within a year if they are not given treament
60%
Length of maintenance antipsychotic therapy usually suggested after a psychotic episode
At least 1-2 years
Antipsychotics to avoid if EPSEs are an issue
Typical antipsychotics, especially risperidone
Antipsychotics to avoid if metabolic syndrome is an issue
Olanzapine
Clozapine
Antipsychotics to try if metabolic syndrome is an issue
Amisulpride
Aripiprazole
Antipsychotic to avoid if raised prolactin is an issue
Amisulpride
Antipsychotics to try if raised prolactin is an issue
Aripiprazole
Olanzapine
Quetiapine
Antipsychotics to try if over-sedation is an issue
Haloperidol
Aripiprazole
Amisulpride
Antipsychotics to try if sexual dysfunction is an issue
Aripiprazole
Quetiapine
Depot antipsychotic which may be the best for relapse prevention
Zuclopenthixol
Depot antipsychotic which has a particularly high EPSE burden
Zuclopenthixol
Depot antipsychotic which may also treat depression
Flupentixol
Depot antipsychotic which may be useful for prevention of mania
Haloperidol
Depot antipsychotic which shows lower rate of EPSEs
Pipotiazine
Depot antipsychotic which may cause depression
Fluphenazine
Depot antipsychotic which needs an aqueous suspension immediately before injection
Risperidone
Depot antipsychotic which does not require a test dose
Risperidone
Risk of NMS with depot compared to oral antipsychotics
Equal
Equivalent chlorpromazine dose which is considered high dose antipsychotic prescribing
1g/day
Percentage of patients with treatment resistant schizophrenia who respond to clozapine within 6 weeks
30%
Percentage of patients with treatment resistant schizophrenia who respond to high dose chlorpromazine
4%
Likely minimum clozapine plasma level required before someone is said to be a non-responder
350-450 ng/ml
Length of time antipsychotics should be tried for before clozapine is tried
6-8 weeks each
Antipsychotics studied in phase one of the CATIE trial
Olanzapine
Quetiapine
Risperidone
Ziprasidone (added later)
Perphenazine
Percentage of patients in the CATIE trial who discontinued treatment within 18 months
74%
Antipsychotic with the lowest discontinuation rate in the CATIE trial
Olanzapine
Antipsychotic with the highest discontinuation rate in the CATIE trial
Quetiapine
Antipsychotic which caused the most weight gain in the CATIE trial
Olanzapine
Antipsychotic studied in phase two of the CATIE trial
Clozapine
Antipsychotic with the lowest discontinuation rate in phase two of the CATIE trial
Clozapine
Antipsychotic with the highest rate of anticholinergic side effects
Clozapine
Comparisons made in the CATIE trial
Olanzapine, quetiapine, risperidone, ziprasidone, and perphenazine against each other in phase one
Clozapine against olanzapine, quetiapine, risperidone, and ziprasidone in phase two
Antipsychotic used in phase one of the CATIE study but not in phase two
Perphenazine
Blindedness of the CATIE study
Double blind
Antipsychotic added part way through the CATIE study
Ziprasidone
Antipsychotics compared in the CUtLASS study
First generation antipsychotics vs. second generation antipsychotics in the first phase
Clozapine vs. second generation antipsychotics in the second phase
Blindedness of the CUtLASS study
Unblinded
Primary outcome of the CUtLASS study
Quality of life at one year
Second generation antipsychotics studied in the CUtLASS study
Amisulpride
Olanzapine
Quetiapine
Risperidone
Findings of phase one of the CUtLASS trial
Slight advantage to first generation antipsychotics over second generation antipsychotics
Findings of phase two of the CUtLASS trial
Significant advantage to clozapine over second generation antipsychotics
Two antipsychotics shown to reduce suicidality among patients with schizophrenia
Olanzapine
Clozapine
Antidepressant which has shown to be effective among patients with body dysmorphic disorder
Fluoxetine
Most effective intervention for antipsychotic related weight gain
Lifestyle modifications
Most effective interventions to reduce waist circumference in schizophrenia
Aripiprazole augmentation
Topiramate
Most effective interventions to reduce glucose levels in schizophrenia
Switch antipsychotic to aripiprazole
Metformin
Most effective interventions to reduce insulin resistancein schizophrenia
Metformin
Rosiglitazone
Risk of tardive dyskinesia for depot antipsychotics compared with oral antipsychotics
Equal
Antipsychotics most associated with weight gain
Olanzapine
Clozapine
Antipsychotics least associated with weight gain
Asenapine
Amisulpride
Aripiprazole
Lurasidone
Ziprasidone
Haloperidol
Most effective antipsychotic at reducing suicidality
Clozapine
Dose of antipsychotic which should be used for a first episode of psychosis compared to in a patient with longstanding psychosis
Lower doses should be used for first episode psychosis
Effect of ketamine given to stable patients with schizophrenia
Transient relapse of psychosis
First generation antipsychotic used in the CATIE study
Perphenazine
NICE guidelines on switching from FGA to SGA
No routine switch needed if patient is responding and happy with current FGA
Antipsychotic with the best evidence for reducing aggression in patients with schizophrenia
Clozapine
Number of hours contact per week with a family member with high expressed emotions which increases the risk of relapse for a patient with schizophrenia
> 35
Psychosocial interventions with the best evidence for the management of schizophrenia
Vocational rehabilitation
CBT
Family therapy
Psychoeducation
Complications of pregnancy which increase risk of schizophrenia in the offspring
Bleeding
HTN
Pre-eclampsia
Diabetes
Rhesus incompatibility
Placental abruption
Premature rupture of membranes
Foetal abnormalities of growth/development which increase risk of schizophrenia later in life
Low birth weight
Prematurity
Congenital malformations
Small head circumference
Delivery complications which increase risk of schizophrenia in the offspring
Hypoxia
Uterine atony
Forceps delivery
EMCS
Resuscitation
Use of an incubator
Single most important factor which increases the risk of hospitalisation among mentally unwell patients
Treatment non-adherence
Positive components in the PANSS scale for schizophrenia
Delusions
Conceptual disorganisation
Hallucinations
Excitement
Grandiosity
Suspiciousness/persecution
Hostility
Negative components in the PANSS scale for schizophrenia
Blunted affect
Emotional withdrawal
Poor rapport
Social withdrawal
Poor abstract thinking
Lack of spontaneity
Stereotyped thinking
Risk of schizophrenia if both parents have schizophrenia
40-50%
MZ concordance for schizophrenia
46%
NICE guidelines for managing cognitive symptoms associated with schizophrenia
Use the lowest effective antipsychotic dose
No evidence for use of any specific agent
Reason why ICD 11 has omitted subtypes of schizophrenia based on descriptive features
Lack of longitudinal stability
Lack of prognostic validity
Lack of usefulness in treatment options
Antipsychotics likely to be useful to treat negative symptoms of schizophrenia
Amisulpride
Cariprazine
Olanzapine
Quetiapine
Increase in risk of developing schizophrenia among people who smoke cannabis
2x increase
Increase in risk of developing schizophrenia among people who smoke cannabis by the age of 15
4x increase
Compared to the general population, number of years earlier people with schizophrenia die
10-20
Average age of onset of schizophrenia in men
23
Average age of onset of schizophrenia in women
26
Male:female rate of schizophrenia over the age of 45
Equal
Amber light results for clozapine monitoring
WCC 3000-3500/mm3
Neutrophils 1500-2000/mm3
Number of times per week blood tests must be taken when a patient has an amber light result
Twice weekly
Mechanism of action behind QTc prolongation caused by antipsychotics
Blocking cardiac potassium channels
Neuropathology findings seen in schizohprenia
Larger ventricles
Decreased brain volume
Decreased grey matter and white matter
Reduced prefrontal lobe volume
Reduced medial temporal lobe volume
Most common symptom of schizophrenia
Loss of insight
Percentage of patients with a first episode of psychosis who experience remission
58%
Length of time where improvement is needed for a patient to have experienced recovery from a first episode of psychosis
2 years
Length of time after which recovery rates stabilise following a first episode of psychosis
2 years
Percentage of patients with a first episode of psychosis who experience recovery
38%
Category in which folie-a-deux is found in ICD 11
Delusional disorder
Sex predominance for folie-a-deux
Female
Risk of schizophrenia with one affected sibling
12-15%
Risk of schizophrenia with one affected parent
12-15%
Risk of schizophrenia with one affected grandparent
6%
Most important baseline blood test to take before starting clozapine therapy
WCC
Scale used to measure symptoms of depression in patients with schizopphrenia
Calgary scale
Antipsychotic which is primarily renally excreted
Amisulpride
Antipsychotic least likely to cause a dry mouth
Amisulpride
Feature most traditionally associated with catatonic schizophrenia
Mannerisms
Percentage of patients with schizophrenia who experience recurrent relapse and continued disability
75%
Likely minimum effective dose of olanzapine in a first episode of psychosis
5mg daily
Likely minimum effective dose of risperidone in a first episode of psychosis
1-2mg daily
Likely minimum effective dose of quetiapine in a first episode of psychosis
150mg daily
Likely minimum effective dose of amisulpride in a first episode of psychosis
400mg daily
Likely minimum effective dose of chlorpromazine in a first episode of psychosis
200mg
Likely minimum effective dose of olanzapine in a relapse of schizophrenia
10mg daily
Likely minimum effective dose of risperidone in a relapse of schizophrenia
3-4mg daily
Likely minimum effective dose of quetiapine in a relapse of schizophrenia
300mg daily
Likely minimum effective dose of amisulpride in a relapse of schizophrenia
800mg daily
Likely minimum effective dose of chlorpromazine in a relapse of schizophrenia
300mg daily
Likely minimum effective dose of haloperidol in a first episode of psychosis
2mg daily
Likely minimum effective dose of haloperidol in a relapse of schizophrenia
> 4mg daily
Likely minimum effective dose of sulpride in a first episode of psychosis
150mg daily
Likely minimum effective dose of sulpride in a relapse of schizophrenia
800mg daily
Antipsychotic least likely to cause conduction problems in a patient with an arrhythmia
Risperidone
Antipsychotic most suitable for a patient with AF
Aripiprazole
Maximum licensed dose for daily oral administration of haloperidol
20mg daily
Maximum licensed dose for daily oral administration of chlorpromazine
1000mg daily
Maximum licensed dose for daily oral administration of olanzapine
20mg daily
Maximum licensed dose for daily oral administration of quetiapine
750-800mg daily
Maximum licensed dose for daily oral administration of risperidone
16mg daily
Maximum licensed dose for daily oral administration of clozapine
900mg daily
Factors which predict a good short term prognosis in schizophrenia
Good initial response to antipsychotics
Good response to placebo
Factors which predict a good long term prognosis in schizohprenia
Acute onset of symptoms
Female sex
Factors which predict a poor short term prognosis in schizophrenia
Daily use of substances
Poor treatment compliance
Factors which predict a poor long term prognosis in schizophrenia
Long duration untreated psychosis
Male sex
Factors which do not have a prognostic significance in schizophrenia
Family history of schizophrenia
Schizophrenia subtype with the earliest age of onset
Hebephrenic
Antipsychotics least likely to cause dyslipidaemia
Aripiprazole
Amisulpride
Antipsychotic least likely to cause QTc prolongation
Aripiprazole
Antipsychotics least likely to cause sexual side effects
Quetiapine
Aripiprazole
Antipsychotics least likely to cause raised prolactin
Quetiapine
Aripiprazole
First line antipsychotic in hepatic impairment
Haloperidol
Second line antipsychotics in hepatic impairment
Sulpride
Amisulpride
Safest antipsychotics in renal impairment
Olanzapine
Haloperidol
Antipsychotics which should be avoided in renal impairment
Amisulpride
Sulpride
Clozapine
Antipsychotics which are safest to use for patients with epilepsy
Haloperidol
Sulpride
Trifluoperazine
Antipsychotics which should be avoided for patients with epilepsy
Clozapine
Chlorpromazine
Antipsychotic least likely to cause a dry mouth
Amisulpride
Antipsychotics most likely to cause weight gain
Olanzapine
Clozapine
Antipsychotics most likely to cause orthostatic hypotension
Risperidone
Clozapine
Antipsychotics least likely to cause sedation
Aripiprazole
Amisulpride
Antipsychotic least likely to cause tardive dyskinesia
Clozapine
Percentage of patients with treatment resistant schizophrenia who respond to clozapine overall
60%
Hours after the last dose a clozapine level should be taken
12
Number of days a patient should be on the same dose of clozapine before a level is taken
7
Medication usually used as a prophylactic anti epileptic with high doses of clozapine
Valproate
Clozapine concentration at which a prophylactic anti epileptic should be considered
> 500 ng/ml
Red light results for clozapine monitoring
WCC <3000mm3
Neutrophils <1500mm3
Percentage of patients treated with clozapine who develop neutropaenia
2.7%
Percentage of patients who develop neutropaenia on clozapine who do so in the first 18 weeks
50%
Risk factors for clozapine induced neutropaenia
Afro-Caribbean race
Young age
Low baseline WCC
Correlation between clozapine dose and development of neutropaenia
None
Case fatality rate of clozapine induced agranulocytosis
3%
Definition of agranulocytosis
Absolute neutrophil count <500mm3
Percentage of patients on clozapine who develop agranulocytosis
0.8%
Risk factors for clozapine induced agranulocytosis
Asian ethnicity
Older age
Recommendation for restarting clozapine after agranulocytosis
Should not be restarted
Mood stabiliser which can raise WCC and has been used to treat clozapine induced neutropaenia
Lithium
Main form of clozapine available in the UK
Clozaril
Length of time after starting clozapine that bloods should be taken weekly
18 weeks
Length of time after starting clozapine that bloods should be taken fortnightly
From week 18-52
Minimum frequency FBC should be checked while on clozapine
Monthly
Action that must be taken after a red light result from clozapine monitoring
Clozapine must be stopped immediately
Percentage of patients taking clozapine who develop hypersalivation
31%
Medications which may be used to treat clozapine induced hypersalivation
Hyoscine hydrobromide
Amisulpride
Percentage of cases of clozapine related myocarditis which develop within the first four weeks of starting treatment
80%
Antipsychotics most often used to augment clozapine efficacy
Amisulpride
Sulpride
Mood stabiliser most often used to augment clozapine efficacy
Lamotrigine
Antipsychotics which should be avoided in augmenting clozapine efficacy
Olanzapine
Sertindole
Pimozide
Muscles most likely to be affected in tardive dyskinesia
Face
Factors which cause an increase in symptoms in tardive dyskinesia
Emotional arousal
Distraction
Factors which cause a decrease in symptoms in tardive dyskinesia
Relaxation
Sleep (disappear in sleep)
Using the affected muscles for voluntary tasks
Length of time after starting an antipsychotic when tardive dyskinesia usually develops
Months to years
Non-modifiable risk factors for tardive dyskinesia
Older age
Female sex
White or African ethnicity
Longer duration of illness
Learning disability
Negative symptoms of schizophrenia
Mood disorders
Non-modifiable risk factors for tardive dyskinesia
Older age
Female sex
White or African ethnicity
Longer duration of illness
Learning disability
Negative symptoms of schizophrenia
Mood disorders
Modifiable risk factors for tardive dyskinesia
Diabetes
Smoking
Alcohol misuse
Substance misuse
Higher antipsychotic dose
Anticholinergic co-treatment
Treatment options for tardive dyskinesia
Stop any anticholinergic drugs
Lower the dose of the antipsychotic
Switch the antipsychotic
Tetrabenazine
Only licensed treatment for tardive dyskinesia in the UK
Tetrabenazine
Prevalence of dystonia with first generation antipsychotic use
10%
Prevalence of Parkinsonian symptoms with first generation antipsychotic use
20%
Prevalence of akathisia with first generation antipsychotic use
25%
Prevalence of tardive dyskinesia with first generation antipsychotic use
5% per year of antipsychotic exposure
Risk factors for antipsychotic related dystonia
Young age
Male sex
Being neuroleptic naive
Use of potent drugs e.g. haloperidol
Risk factors for antipsychotic related Parkinsonism
Old age
Female sex
Pre-existing neurological damage
Time after starting antipsychotics when dystonia develops
Minutes to hours
Time after starting antipsychotics when Parkinsonism develops
Days to week after starting or increasing dose
Time after starting antipsychotics when Parkinsonism develops
Days to week after starting or increasing dose
Time after starting antipsychotics when akathisia develops
Hours to weeks
Treatment options for antipsychotic induced dystonia
Anticholinergic drugs e.g. procyclidine
Switch antipsychotic
Botulinum toxin
Treatment options for antipsychotic induced Parkinsonism
Reduce the dose
Anticholinergics e.g. procyclidine
Switch antipsychotic
Treatment options for antipsychotic induced akathisia
Reduce the dose
Switch antipsychotic - quetiapine/olanzapine suggested
Propranolol
Mirtazapine
Mianserin
Anticholinergic drugs e.g. procyclidine
Cyproheptadine
Benzodiazepines e.g. diazepam or clonazepam
Clonidine
Likely therapeutic range for D2 receptor occupancy in antipsychotic treatment
65-80%
D2 receptor occupancy in antipsychotic treatment at which EPSEs are likely to develop
80%
Most difficult EPSE to treat
Akathisia
Percentage of patients in the CATIE trial with metabolic syndrome
40%
Percentage of male patients in the CATIE trial with metabolic syndrome
36%
Percentage of female patients in the CATIE trial with metabolic syndrome
51%
Antipsychotic most associated with hypertension
Clozapine
Antipsychotics advised for patients with diabetes
Amisulpride
Aripiprazole
Ziprasidone
Proportion of patients who stop clozapine due to agranulocytosis or neutropaenia who will develop a blood dyscrasia on re-challenge
1/3
Antipsychotic most likely to cause sedation
Clozapine
Length of time acute and transient psychotic disorder lasts
Up to three months (usually up to one month)
Features of acute and transient psychotic disorder
Rapid onset of psychosis with no prodrome
Symptoms change rapidly from day to day or within a day
Absence of negative symptoms
Antipsychotic most associated with raised TSH levels
Aripiprazole
ICD 11 diagnosis for psychotic symptoms that last up to three months
Acute and transient psychosis
DSM V diagnosis for psychotic symptoms that last up to a month
Brief psychotic disorder
DSM V diagnosis for psychotic symptoms that last longer than a month but less than six months
Schizophreniform disorder
Hypothesis which attempts to explain the link between schizophrenia and social class
Selection drift hypothesis
Antipsychotic which has been shown to have benefit in the treatment of post-operative delirium
Haloperidol
Sex where expressed emotion has a greater negative impact in schizophrenia
Male
Sex where neurological soft signs are more prevalent in schizophrenia
Male
Length of time a trial of clozapine should last
8 weeks
Percentage of patients with schizophrenia treated with an antipsychotic who will be non-compliant after 24 months
75%
Antibiotic which has been shown to have effect in treatment resistant schizophrenia
Minocycline
Sleep impairments often found in schizophrenia
Decreased REM latency
Decreased proportion of slow wave sleep
Relative risk for schizophrenia among first generation migrants
2.7
Relative risk for schizophrenia among second generation migrants
4.5
Percentage of patients non-compliant with antipsychotic treatment who are purposefully non-compliant
90%
Long term risks of antipsychotic associated hyperprolactinaemia
Breast cancer
Osteoporosis
Percentage of people with visual impairment who suffer from Charles Bonnet syndrome
12%
Length of time an antipsychotic should be continued after successful treatment of a first episode of psychosis
6 months
Most common feature of persistent delusional disorder
Non-bizarre delusions
Depot medication which requires at least 2 hours’ monitoring after it is given
Olanzapine
Reason olanzapine depot requires at least 2 hours’ monitoring after being given
Small risk of olanzapine post-injection syndrome
Features of olanzapine post-injection syndrome
Sedation
Delirium
Dizziness
EPSEs
Aggression
Seizures
Cognitive deficit most often seen in schizophrenia
Working memory
Parkinsonian symptom most commonly seen with antipsychotic use
Rigidity
Average clozapine:norclozapine ratio if the level is taken at the correct time
1.3
Proportion of people taking clozapine who die from agranulocytosis
1 in 10,000
Mean standardised mortality ratio of a person with schizophrenia
2-3
Type of psychosis associated with a dream-like state
Oneiroid psychosis
Antipsychotic suggested when tardive dyskinesia is an issue
Clozapine
Quetiapine
Percentage of patients with schizophrenia who are treatment resistant
30%
Length of time a trial of antipsychotic therapy (except clozapine) should last
4-6 weeks
Alternative term for a loading dose of antipsychotic therapy
Rapid neuroleptisation
Advice on loading dose of antipsychotic therapy
Advised not to give
Antipsychotic which requires advice to be given about risk of sunburn
Chlorpromazine
