Lecture 17 - Antipsychotics

Question 1

What is dementia praecox?

Answer 1

Cognitive problems associated with aging

Question 2

What name was given to replace dementia praecox?

Answer 2

Schizophrenia

Question 3

What are particular disorder a constellation of?

Answer 3

Number of signs and symptoms

Question 4

What is schizophrenia?

Answer 4

A psychotic disorder characterised by loss of contact with the environment - deterioration in level of functioning in everyday life - disintegration of personality

Question 5

Schizophrenia

Answer 5

Disorder of feeling, thought, perception and behaviour

Question 6

What are the positive symptoms?

Answer 6

Any change in behaviour or thoughts (hallucinations or delusions) Hallucination Disorganised speech Disorganised or catatonic behaviour

Question 7

What are negative symptoms?

Answer 7

Withdrawal or lack of function; emotionless and flat Anhedonia Lack of motivation

Question 8

What symptoms are more responsive to therapeutic drugs?

Answer 8

Positive symptoms

Question 9

What symptom is more difficult to treat?

Answer 9

Negative symptoms

Question 10

What mode is hallucination found in?

Answer 10

Auditory - form of voices being heard in head, thinking their thoughts are being broadcast

Question 11

What are the characteristics of positive symptoms?

Answer 11

Disorganised speech and behaviour

Question 12

What behaviour do some individuals display that appear to make them withdrawn from society

Answer 12

Catatonic

Question 13

What is anhedonia

Answer 13

When an individual doesn’t experience pleasure in anything

Question 14

What are key symptoms of depression?

Answer 14

Anhedonia and lack of motivation

Question 15

Why does DSM-V exist?

Answer 15

Attempt to distinguish certain pattern of symptoms to aid treatment options that are available

Question 16

Why is there an increase in ventricular size after disease develops?

Answer 16

Loss of brain tissue (grey matter)

Question 17

What does the loss of gray matter anywhere in brain result in?

Answer 17

Increase in ventricular size

Question 18

What brain regions are associated with grey matter loss?

Answer 18

Cortical areas and Hippocampus

Question 19

What are developed to understand schizophrenia?

Answer 19

Animal models

Question 20

What destroys certain neuronal pathways?

Answer 20

Infusion of ibotenic acid

Question 21

What does the animal model suggest?

Answer 21

There is damage in the form of a lesion to the hippocampus soon after birth

Question 22

Following hippocampal lesions what are some deficits observed?

Answer 22

Deficit in social interaction Aggressive behaviour Deficits in grooming

Question 23

Going from puberty to young adulthood what developmental plaice like symptoms are observed?

Answer 23

Locomotor hypersensitivity to amphetamine Hyperresponsiveness to stress Enhanced sensitivity to NMDA antagonist Deficit in sensorimotor gating and ppi

Question 24

In the model what are some cognitive like symptoms observed?

Answer 24

Deficit in working memory Deficit in spatial learning and memory Deficit is in place learning

Question 25

What did Carlson and Lindqvist hypothesise?

Answer 25

Dopaminergic transmission is altered in schizophrenia ‘the original dopamine hypothesis’

Question 26

What is the original dopamine hypothesis ?

Answer 26

There is an increase in dopamine within CNS in the brain that gives signs and symptoms that are related to schizophrenia

Question 27

What drug was initially developed to be used for anaesthesia

Answer 27

Largactil - now known as chlorpromazine

Question 28

What effect did chlorpromazine produce in schizophrenic individuals?

Answer 28

Calming effects and allow schizophrenic to live a normal life

Question 29

What is chlorpromazine in terms of receptor ?

Answer 29

Dopamine receptor antagonist

Question 30

Chlorpromazine is an example of what type of drug?

Answer 30

Phenothiazine

Question 31

What is the structure of chlorpromazine ?

Answer 31

3 rings with 2 functional groups

Question 32

What is schizophrenia due to?

Answer 32

Overactivity if dopamine at D2 receptors

Question 33

How many dopaminergic pathways are there in the brain!

Answer 33

3

Question 34

A9 substantial nigra pathway

Answer 34

Project from substantial nigra into striatum (caudate, putamen and Globus Pallidus) Coordination of movement

Question 35

A10 ventral tegmental area pathway

Answer 35

Mesoaccumbens pathways Tied to more basic functions I.e experience of pleasure (pleasure centre activator) Associated with pleasurable effects associated with drug abuse

Question 36

A10 ventral tegmental area

Answer 36

Mesocortical pathway Tied up with more cortical and cognitive functions

Question 37

In all three pathways what is there an increase of ?

Answer 37

Dopamine

Question 38

What is dopaminergic hypofunction?

Answer 38

Drop in levels of dopamine

Question 39

What did Davis propose

Answer 39

Damage to to the dopaminergic pathway that projects to the cortex (mesocortical pathway) hence reduction in dopamine

Question 40

What does reduced inhibitory effect cause?

Answer 40

Increase develops of dopamine

Question 41

Where is there an increase in dopamine?

Answer 41

Mesolimbic pathway

Question 42

Where is there a decrease in dopamine?

Answer 42

Mesocortical pathway

Question 43

What are negative symptoms associated with?

Answer 43

Hypofrontality (reduced dopamine in the frontal cortex)

Question 44

What are positive symptoms due to?

Answer 44

Overactivity in the mesolimbic system

Question 45

If the A9 pathway is blocked what symptoms are mimicked?

Answer 45

Parkinson’s disease

Question 46

What does the antagonist action at 5HT2A receptors do?

Answer 46

Directly or indirectly increase cortical dopamine

Question 47

What is the pre pulse inhibition of startle ?

Answer 47

Expose experimental animal/ human to startling noise they will hum and have some sort of response

Question 48

What does accelerometer measure?

Answer 48

Changes in force

Question 49

What does amphetamine have an effect upon?

Answer 49

Dopaminergic system

Question 50

What effect does ketamine have?

Answer 50

Glutamatergic systems

Question 51

Where is the neurochemical lesion located?

Answer 51

Neonatal ventricular hippocampal region