schizophrenia

Question 1

Four main NT involved in Schizo

Answer 1

Dopamine
Serotonin
Glutamate
GABA

Question 2

Schizophrenia: decreased dopamine in which region? (hypofrontality)

Answer 2

PFC

Question 3

Schizophrenia: increased dopamine in which region?

Answer 3

Nucleus Accumbens (D2 receptors)

Question 4

in schizophrenia decreased DA in the PFC is responsible for

Answer 4

cognitive deficits / negative symptoms

Question 5

in schizophrenia increased DA in the NA is responsible for

Answer 5

positive symptoms

Question 6

mesolimbic dopamine

Answer 6

dopamine in NA = increased in schiz

Question 7

what system is abnormal in schizophrenia

Answer 7

mesocorticolimbic dopamine system

Question 8

enhanced neurotransmission at what receptors produces positive symptoms of schizo?

Answer 8

D2 receptors pre and post synaptically

Question 9

First Generation Neuroleptics

Answer 9

phenothiazines, thioxanthines, antiemetics, butyrophenones, diphenylbutylpiperidines

Question 10

First Generation Neuroleptics Method of Action

Answer 10

ANTAGONISE DA RECEPTORS
(block d1 and d2 receptors)

Question 11

Benefit of butyrophenones & diphenylbutylpiperidines compared to other first gen antipsychotics

Answer 11

reduced sedative effects compared to the others

Question 12

negatives to first generation antipsychotics

Answer 12

they have no effect on negative or cognitive symptoms, ineffective in 30% patients, relapse rate, intolerable side effects (cardiotoxicity)

Question 13

VTA dopamine pathway is involved in…

Answer 13

reward, psychosis and movement

Question 14

Effect of 1st Gen antipsychotics on nigrostriatal dopamine system?

Answer 14

decreased DA (blocking of D1 receptors) results in impaired movement (Parkinson’s symptoms)

Question 15

pyramidal

Answer 15

voluntary movement

Question 16

extrapyramidal

Answer 16

subconscious movement (nigrostriatal DA system)

Question 17

why 1st Gen antipsychotics caused extrapyramidal side effects

Answer 17

blocked 80% of d2 receptors = antipsychotic
also had an effect on D1 receptors responsible for movement (causing extrapyramidal side effects)

Question 18

2nd Gen Typical Antipsychotic

Answer 18

Benzamides

Question 19

Action of benzamides

Answer 19

highly selective for D2 receptors meaning less extrapyramidal side effects but still no effect on negative or cognitive symptoms

Question 20

Suspected Involvement of Serotonin in Schizophrenia

Answer 20

• modulates mesocorticolimbic DA system
• may encourage DA deficit in PFC
• increases DA release in NA

Question 21

drugs activating 5-HT2 receptors produce…

Answer 21

schizophrenia like symptoms

Question 22

Atypical antipsychotics benefits

Answer 22

attenuates both positive and negative systems, no extra pyramidal side effects

Question 23

Atypical antipsychotics negatives

Answer 23

agranulocytosis - suppression of immunity

Question 24

types of atypical antipsychotics

Answer 24

multiple receptor antagonists (differing affinities)
Selective 5-HT2/ D2 antagonists

Question 25

How is glutamate involved in schizophrenia

Answer 25

glutamate neurotransmission is reduced, glutamate opens NDMA receptors, reducing this induces psychosis as NDMA receptors aren't opened letting in Glut to excite GABA to reduce GLut again in PFC

Question 26

Novel Antipsychotics

Answer 26

NMDA receptor modulators