Treatment in schizophrenia Flashcards
D2 receptor antagonist (dopamine) mesolimbic pathway
Haloperidol
which drug enhance cognition and concentration in schizophrenia along with antipsychotic properties?
Lurasidone
extra pyramidal side effects?
- acute dystonic reaction
- Parkinsonism
- tardive dyskinesia
dopaminergic side effects?
- extra pyramidal side effects
- neuroleptic malignant syndrome
- hyperprolactinaemia
- akathisia/ restless legs
Neuroleptic malignant syndorme clinical picture?
- rare
- onset over hours (24-72)
lasts for days untreated
Clinical presentation-
- increasing muscle tone
- pyrexia
- changing pulse/BP which then causes-
- rhabdo
- ARF
- coma
- death
NMS investigation?
creatinine kinase
NMS treatment?
-stop antipsychotic
- rapid cooling
- renal support
- skeletal muscle relaxant- DANTROLINE
- dopamine agonists- BROMOCRIPTINE
what is prolactin- tuberoinfundibulnar situation?
-prolactin release is inhibited by dopamine
- blockage of dopamine leads to increased prolactin release
in female-
- galactorrhea
- decrease libido
- decrease arousal
- anorgasmia
in men-
- gynaecomastia
- erectile dysfunction
- oligospermia
- decrease libido
in both-
- decrease bone mineralisation
- decrease bone density leading to osteoporosis
- more falls and more fractures
treatment of akathisia?
akathisia is inability to sit for longer hours
1st line treatment- propranolol
2nd line- clonazepam (benzodiazepines)
prolonged Qt interval cause?
caused by antipsychotics and Is one of the side effects of it
treatment resistant schizophrenia what should be given?
Clozapine
good for negative symptoms and antisuicidal
side effects of clozapine?
- agranulocytosis > neutropenic sepsis
- myocarditis
- constipation–> perforation
- weight gain
- sedation
- sialorrhoea
if a patient on antipsychotics present with falls
it is due to EPSE