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11 Cards in this Set
- Front
- Back
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Psychoses
Two subdivisions: |
o Organic (of known cause) psychoses
§ Associated with causes that are understood and definable § Are characterized by confusion, disorientation, memory disturbances, and behavioural disorganization o Functional (of unknown cause) psychoses § Characterized by retention of orientation and memory in the presence of severely disordered thought or reasoning, emotion, and behaviour |
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The Serotonin Hypothesisof Schizophrenia
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o The discovery that LSD causes hallucinations and is a serotonin receptor agonist led to the search for endogenous hallucinogens in the urine of schizophrenic patients
o None were found |
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· The Dopamine Hypothesis of Schizophrenia
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o Evidence suggest that excessive dopaminergic activity explains this disorder:
1. Most of the typical antipsychotic drugs are potent blocker of postsynaptic dopamine receptors in the CNS. The binding affinity of antipsychotic drugs to the dopamine receptor is highly correlation with their clinical antipschochtic potency 2. Drugs that increase dopaminergic activity either aggravate schizophrenia or induce it in some individuals. 3. Dopamine receptor density has been found in post-mortem studies to be increased in the brains of schizophrenics who had not been treated 4. Using a technique known as PET, dopamine receptor density has been show to be higher in brains of people suffering from schizophrenia than in non-schizophrenic people |
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· The Glutamate Hypothesis of Schizophrenia
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o Glutamate is the major excitatory neurotransmitter in the brain
o Many hallucinogens are inhibitors at a subset of glutamate receptors (NMDA type) and exacerbate impairment and psychosis in patients with schizophrenia o These observations have been used in an attempt to develop novel antipsychotic drugs |
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· The Phenothiazine Antipsychotic Drugs
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o Patientswho were hospitalized for years could be treated as outpatients o Wasrecognized as a neurotransmitter in the CNS o Shownthat the effects of dopamine on electrical activity in synapses of the CNScould be blocked by the phenothiazine antipsychotic o Concludedthat phenothiazine antipsychotics are antagonists at dopamine receptors |
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Blockadeof Dopamine Receptors |
· Can be explained by the antagonism of dopamine receptors in the mesolimbic and mesofrontal systems of the brain (meso=middle) (limbic=controls emotion and behaviour)
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Blockadeof Dopamine Receptors |
· Can result is extrapyramidal movement disorders
· Parkinson’s, Tardive dyskinesia, dystonia and akathesia like symptoms · Endocrine effects: prolactin release from the pituitary gland. Women = breast milk and menstrual changes. Men – sexual dysfunction |
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Biopolar Disorder
· Lithium Carbonate |
o Moodstabilizer
o Preventsmood swings o Twopossibilities for action: § Effect on electrolytesand ion transport § Effect on secondmessengers that mediate transmitter action |
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o Clinical Pharmacology of Lithium
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§ 2-4 weeks to have full effect
§ May require an antipsychotic or antidepressant |
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o Adverse Effects of Lithium
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§ Nausea, fatigue
§ Tremor, thirst,excessive urination, edema, weight gain § Confusion and loss ofmuscle coordination § Acne and skin reactions § Mild hypothyroidism § Toxic kidney effects § When taken duringpregnancy, cardiac malformations in fetus |
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Other Uses for the Atypical Antipsychotics
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· Treat: o Delusionsand aggression in dementiao Autism o Developmentaldisorder o Posttraumaticstress disorder o Obsessivecompulsive disorder o Borderlinepersonality disorder
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