Schizophrenia + Psychosis Flashcards
symptoms of schizophrenia
delusion
3rd person auditory hallucinations
thought inteference
passivity disorder
schizophrenic behaviour is described as…
catatonic (eg excitement, posturing, negativism)
name the 3 subtypes of schzophrenia
paranoid
hebephrenic
subtypes
how do hebephrenic schizophrenia patients present?
immature
silly
agitated
main clinical feature of catatonic schizophrenia?
abnormal movement
most common form of schizophrenia?
paranoid
preluding condition to schizophrenia? what’s the main difference?
schizotypal disorder
don’t get as prominent hallucinations/delusions
negative symptoms of schizophrenia
reduced speech, motivation, drive, interest, pleasure, social interaction
what is affect like in schizophrenia?
blunted
who gets schizophrenia?
young people
peak ages 15-25 years for men, 25-35 for women
risk factors for schizophrenia?
genetic susceptibility birth complications drug use urban dwelling social deprivation neurochemical changes eg altered dopamine signalling
premorbid symptoms of schizophrenia?
subtle motor, cognitive and social deficits as a child that get slowly worse
odd behaviour and experiences
when are schizophrenic patients most likely to commit suicide?
when they recover their insight
1 week after discharge
pathophysiology of schizophenia?
overactivity of dopamine pathways in the brain
what brain pathway controls release of prolactin
tuberoinfundibular
what does the nigrostriatal pathway control
extrapyramidal motor system
D2 receptors open _ channels
K+
D2 receptors inhibit _ channels
Ca
dopamine overactivity leads to….
psychosis
__activity of NMDA can cause psychosis
over
what is neuregulin and what does it do?
a signalling protein that mediates cell-cell interactions and plays a part in growth and development of multiple organ systems
main side effects of antipsychotics?
extrapyramidal
give examples of extrapyramidal symptoms
acute dyskinesias dystonic reactions tardive dyskinesia Parkinsonism akinesia akathisia
atypical antipsychotics are less likely to cause extra-pyramidal side effects than typical antipsychotics T or F
T
olanzapine is an example of a/an….
atypical antipsychotic
acute dystonic reactions are painful T or F
T
Tx for acute dystonic reaction
anti-cholinergics
what is akathisia?
constant restlessness
Tx of akathisia
reduce dose
change drug
anticholinergics dont work
presentation of tardive dyskinesia is mainly located where…
orofacial eg tongue out etc
why do you get extrapyramidal symptoms from antipsychotics?
they downregulate dopamine which causes ACh levels to go up (work like a see-saw), ACh excites neurons so causes symptoms like tremor and dyskinesias etc
dopamine ___ whereas ACh ____
inhibits
excites
what is the main complication of 5-HT2 antagonists?
metabolic syndrome
side effects of drugs that block histamine?
sedation
increased appetite
muscarinic receptors are the target of the ___ nervous system
parasympathetic
what neurotransmitter is known for its sedative effect?
histamine
what antipsychotic is least likely to cause extra-pyramidal effects?
quetiapine
quetiapine and olanzapine are atypical antipsychotics T or F
T
most effective antipsychotic
clozapine (BUT it kills people)
main complication of clozapine? what other side effects are there
agranulocytosis
also get metabolic syndrome and hypersalivation
myocarditis
how often do you need blood tests if youre on your first 6 months of clozapine?
weekly
when can you stop getting blood tests for clozapine
after 1 month of cessation
blood test frequency on 6-12th month of clozapine?
fortnightly
what cardiac problem can be caused by clozapine?
myocarditis
