Schizophrenia & Antipsychotics Flashcards
Schizophrenia: Age of onset?
Usually young adults
(15-25)
Major difference between psychotic episodes in Mania vs. Schizophrenia?
Mania patients return to baseline following psychotic episodes, regardless of how psychotic they are during the episode (memory,
Schizophrenicss do not fully return to baseline - come back, but not all the way to baseline – deteriorating course
T or F? Schizophrenia genetic risk is conferred via an identified SNP mutation.
False, there is a very long list of candidate genes that may confer susceptibility to Schizophrenia
T or F? A non-dysfunctional environment growing up can completely eliminate the risk of a child having Schizophrenia, even if one of their parents has Schizophrenia.
True.
Otherwise, child has a 10% risk of developing it.
Perinatal complications that may lead to Schizophrenia?
- 2nd trimester infection
- Winter birth
- Toxic exposure
- Perinatal anoxia (think: Jenny)
Chronic schizophrenia is ass’d w/ dec’d brain volume, particularly ______.
What other structural finding is specifically ass’d w/ Schizophrenia
- particularly gray matter (though there is also some white matter dysfunction)
Also see “hypofrontality” often (impaired working memory – card test)
What structural finding of the brain is specifically ass’d w/ a worse prognosis in Schizophrenic patients?
Dilated lateral ventricles
though, this is NOT pathognomonic for Schizophrenia
“Positive” symptoms of Schizophrenia are thought to be caused by hyper- or hypo-activity of what brain pathway?
hypERactivity of Mesolimbic pathway
“Negative” symptoms of Schizophrenia are thought to be caused by hyper- or hypo-activity of what brain pathway?
hypOactivity of Mesocortical pathway
Classic antipsychotics: MOA?
Block D2
Atypical antipsychotics: MOA?
Block 5HT (some also block D2 @ higher doses)
D2 blockers improve what symptoms in Schizophrenia?
They improve positive symptoms
do not improve negative symptoms, in fact side effects may exacerbate them
Hyperprolactinemia may occur due to hypo activity of which brain pathway?
Tuberoinfundibular pathway
may occur as result of D2-blockers in Schizo Tx
For Schizo diagnosis, you must have __(time)__ of ACTIVE hallucinations, delusions, and/or disorganized speech.
1 month
Also must have:
- Continuous signs of disturbance for at least 6 months)
- Social/ occupational dysfunction
• Work
• Interpersonal relations
• Self-care
What is the microscopic explanation of Tardive Dyskinesia?
Supersensitivity to D2-receptors as a result of blocking them w/ drugs
(thus may occur after ~3 months of Schizophrenia Tx & is very serious b/c can result in permanent super sensitivity of receptors)
