Flashcards in General about schizophrenia, affective disorders, bipolar disorder Deck (14)
Types of symptoms of schizophrenia
Positive symptoms: Delusions, hallucinations.
Negative symptoms: Withdrawal, apathy, lack of motivation
Neuronal pathways responsible for symptoms in schizophrenia
Positive symptoms: Excessive activity in mesolimbic pathways.
Negative symptoms: Insufficient activity in mesocortical pathways.
Mechanism of the therapeutic effect of antipsychotic drugs
Competitive blockade of dopamine and serotonin receptors
Changes in dopamine neurotransmission caused by antipsychotics
1. Increased synthesis, release and metabolism.
2. Depolarization blockade, inactivation of dopaminergic neurons.
3. Dopamine up-regulation and supersensitivity to dopamine agonists.
Supersensitivity can cause...
Tarditive dyskinesia (delayed type extrapyramidal symptoms)
Adverse effects of all antipsychotics
Peripheral alpha1-blockade: Dizziness, hypotension, reflex tachycardia.
Peripheral muscarinic blockade: Dry mouth, constipation, blurred vision, urinary retention.
Central histamine 1 blockade: Drowsiness, weight gain.
Neuroleptic malignant syndrome
Neuroleptic malignant syndrome - symptoms and treatment
Muscle rigidity, elevated temperature, altered consciousness, autonomic dysfunction (tachycardia, diaphoresis, tachypnea, urinary and fecal incontinence).
Treatment: dantrolene, supportive care.
Antipsychotics - indications
Schizophrenia, psychosis (drug-induced, mania during bipolar disease)
Agitated pts with e.g. dementia and mental retardation.
Phenothiazines: Some for vomiting and nausea.
Treatment for acute EPSs
Benztropine, diphenhydramine, amantadine.
Treatment for tarditive dyskinesia
Off label: amantadine, dopamine receptor agonists, clozapine, physostigmine, benzodiazepine.
Withdrawal syndrome from antipsychotics
Nausea, vomiting, diarrhea.
Groups of drugs used in affective disorder
Antidepressants and mood-stabilizers
MOA for antidepressant drugs
Increase serotonin, norepinephrine and dopamine neurotransmission.
Increased synaptic concentration of serotonin, cause down-regulation of presynaptic autoreceptors. Increased firing rate of serotoergic neurons.