Schizophrenia

Question 1

What is Schizophrenia

Answer 1

debilitating psychotic illness, difficulty perceiving reality

Question 2

Most well-known symptoms of schizophrenia

Answer 2

Hallucinations
- auditory
- visual
Delusions
- paranoia
- grandiose

Question 3

Positive symptoms definition, examples of schizophrenia

Answer 3

behaviours not normal in healthy people

• disorganized speech
• disorganized flow, the content of thoughts
• an absence of goal-oriented behaviours
• nonsensical rhymes, neologism

Question 4

Negative symptoms, def., examples

Answer 4

loss of normal behaviours found in healthy people

• social withdrawal
• flattened mood
• cognitive impairments, memory, function
• usually comorbidities

Question 5

What % of the worlds population is affected?

Answer 5

1%

Question 6

What factors contribute to risk?

Answer 6

Genetics

Environment

Question 7

Which pair would imply more heritability, fraternal or identical twins?

Answer 7

Identical twins, 50-80% concordance

Question 8

When is it usually onset?

Answer 8

early adulthood
men, 18-20
women, 24-30

Question 9

Environmental factors

Answer 9

Maternal infection
maternal starvation
obstetric complications 
cat feces, glondii
low socioeconomic status
urbanicity 
drug abuse 
physical/psychological trauma, childhood

Question 10

historical treatments of schizophrenia

Answer 10

institutionalized
induced seizure
induced hypoglycemia (low blood sugar levels)
frontal lobotomy 
sedatives, barbiturates
psychotherapy

Question 11

first antipsychotic?

Answer 11

chlorpromazine

Question 12

MOA of chlorpromazine

Answer 12

D2 anatagonist

Question 13

Screening method for drugs developed right after chlorpromazine

Answer 13

motor impairing drugs, if they did not, they were not pursued

Question 14

Traits of typical APS

Answer 14

motor impairment

D2 antagonists

Question 15

Traits of atypical APS

Answer 15

do not act as much on D2, but on 5HT

could have dual action

Question 15

Traits of atypical APS

Answer 15

do not act as much on D2, but on 5HT

could have dual action

Question 16

rational drug development, schizophrenia

Answer 16

drugs that act on D2, 5HT

Question 17

Name typical APS

Answer 17

Chlorpromazine

Haloperidol

Question 18

Name atypical APS

Answer 18

clozapine
risperidone
olanzapine

Question 19

Why do typical APS impair motor function?

Answer 19

blocking D2, dopamine facilitates movement

Question 20

What is anhedonia

Answer 20

reduced or inability to feel pleasure, especially from things you would normally enjoy

Question 21

Reproductive hormone effects

Answer 21

D2 in the pituitary gland
prolactin increase
men and women lactate
men, breast development
women, prevents menstruation

Question 22

What is the most effective treatment for schizophrenia currently?

Answer 22

clozapine, atypical

Question 23

a rare side effect of clozapine?

Answer 23

loss of white blood cells

Question 24

MOA of clozapine

Answer 24

antagonist fo 5HT,

Question 25

what drug led to rational drug development and what was it?

Answer 25

clozapine | drugs that block D2 or 5HT

Question 26

What are the other atypical APS, that are usually prescribed first?

Answer 26

risperidone aripiprazole (olanzapine)

Question 27

side effects of atypical

Answer 27

metabolic syndrome weight gain type 2 diabetes risks of heart disease

Question 28

Efficacy of APS

Answer 28

can treat positive symptoms, limited for negative symptoms

Question 29

what drug is the exception when it comes to treating negative symptoms?

Answer 29

clozapine

Question 30

what fraction of patients arent helped by APS

Answer 30

1/3

Question 31

"treatment resistant"

Answer 31

showing no results after trying 2-3 different APS

Question 32

Dual action APS

Answer 32

risperidone | olanzapine

Question 33

the ratio of men to women affected?

Answer 33

1.4:1

Question 34

How much does genetics play a role?

Answer 34

80%

Question 35

avolition

Answer 35

decreased motivation, no motivation

Question 36

what drug effects were they looking for prior to to making chlorpromazine

Answer 36

reduced antihistamine enhanced sedative properties

Question 37

anti-emetic properties

Answer 37

anti-nausea and vomiting

Question 38

clozapine and catalepsy

Answer 38

catalepsy, involuntary movement | clozapine was effective without inducing catalespy

Question 39

1st generation APS, typical side effects

Answer 39

motor-impairment/parkinsons/extrapyramidal hormonal effects tardive dyskinesia (involuntary neurological movement)

Question 40

new ideas about schizophrenia

Answer 40

``` not one gene changed in every patient umbrella diagnosis thoughts: - rare mutation - several risk genes ```