Schizophrenia + Antipsychotic drugs Flashcards
Schizophrenia Triad core symptoms
Positive Symptoms- hallucinations, delusions, agitation, disorganised thinking
Negative Symptoms- introversion, apathy, low self-esteem, personal neglect
Cognitive Symptoms- poor memory (working memory particularly affected), attention deficit, executive dysfunction
Schizophrenia diagnosis
At least two of: - delusions - hallucinations - disorganised speech - disorganised or catatonic behaviour - negative symptoms Must persistent for at least 6 months- 1 of these must be active symptoms
Schizophrenia + genese
Dysbindin
Neuregulin 1
COMT
Schizophrenia is highly…
Polymorphic
Classification of schizophrenia
Paranoid Disorganised Catatonic Undifferentiated Residual
Frontal cortical dysfunction testing
Wisconsin Card Sorting Test
Structural changes in Schizophrenia
Larger ventricles
Smaller medial temporal lobe structures
Grey matter loss
Hypofrontality
Decreased frontal activation in schizophrenia
Schizophrenia beginning
Associated with decreased synaptic spines and decreased dendritic complexity in the cortex
Schizophrenia risk factors
Complications during pregnancy or at birth
Older father
Immune system activation
Excessive cannabis use
Schizophrenia + inflammation
Prenatal infection + increased levels of cytokines during pregnancy increase risk of SCH in offspring
Pro-inflammatory cytokines are elevated in prefrontal cortex of SCH patients
Increased loss of grey matter in those with high levels of cytokines
Greater immune cell migration to brain
Activated microglia
Schizophrenia, white matter + myelination
Reduced oligodendrocyte density in SCH
Inflammation + immune activation –> oligodendrocyte damage
Global decreased white matter integrity
Schizophrenia + brain connectivity
Altered brain connectivity of the default brain network
–> increased
Schizophrenia + dopaminergic pathways in CNS
Hyperactivity in mesolimbic pathway
Hypoactivity in mesocortical pathway
Drug targets
Dopamine D2 type (D2,3,4)
All drugs act as antagonists here
Chlorpromazine
Antipsychotic
Typical antipsychotics
Chlorpromazine
Thioridazine
Fluphenazine
Atypical antipsychotics
Risperidone Olanzapine Clozapine Quetiapine Improve cognition Significant antagonist activity at 5HT2 receptors
Clozapine
Blocks D4 receptors
Aripiprazole
Partial agonist at presynaptic D2 receptors
Antagonist at D2 postsynaptic receptors
Antipsychotics SE
Prolactin rise
Weight gain
Dyslipidaemia
Type 2 diabetes
Atypicals
Less EPS, cardiotoxicity and hyperprolactinaema compared to typicals
Neuroleptic malignant syndrome
Hyperpraxia
Muscle rigidity
Tremor
Confusion
Tardive dyskinesia
Involuntary movements of lips jaw face
Grimacing
Constant chewing
Tongue thrusting
Schizophrenia + glutamate
Decreased glutamatergic transmission
