Exam 5 - Lecture 6
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| Types of Psychiatric Disorders | Neurotic Disorders, Psychotic Disorders, Mood/Affective Disorders, and Others (Personailty Disorders and Dissociative Disorders)
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| Neurotic Disorders are ________ thought/feeling involving a(n) _________ stimulus | Abnormal thought/feeling involving a Real stimulus
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| Psychotic Disorders are ________ thought/feeling involving a(n) _________ stimulus | Normal thought/feeling involving an Unreal stimulus
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| Mood/Affective Disorders are ________ emotional states that are ________ to a stimulus | Abnormal emotional states that are Irrelevant to a stimulus
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| Neurotic Disorders cause abnormal: | Stress (anxiety), Fear (phobia), Desire (fetish), Impulse (-mania)
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| Psychotic Disorders cause: | Delusion, Hallucination
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| Mood/Affective Disorders cause abnormal states of: | Sadness, Happiness, Irritability, Anger
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| Schizophrenia is what kind of disorder? | Psychotic
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| Depression is what kind of disorder? | Mood/Affective Disorder
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| Mania is what kind of disorder? | Mood/Affective Disorder
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| Bipolar is what kind of disorder? | Mood/Affective Disorder
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| Characteristics of a Personality Disorder | Mix of all three (neurotic, psychotic, and mood/affective) disorders but with relationship/social/cultural conflicts
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| Characteristics of a Dissociative Disorder | Any aspects of the three (neurotic, psychotic, or mood/affective) disorders but with loss of self-awareness
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| What is the most common psychotic disorder? | Schizophrenia
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| Schizophrenia | Most common psychotic disorder, means “split mind” (from reality), psychotic with social/occupational dysfunction
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| Schizophrenia affets about ___% of the U.S. population | 1%
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| Hereditary factor Schizophrenia is ___% for close relatives and ___% for identical twins | 10% for close relatives and 50% for identical twins
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| Neurodevelopmental factors associated with Schizophrenia | Thiamine deficiency? Virus? Maternal stress? Problems with neuron proliferation, neuron myelination, or neurotransmitter receptor expression
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| Clear Schizophrenia symptoms begin in __________ | Adolescence
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| Negative Symptoms of Schizophrenia | Withdrawal from social contacts, Flattening of emotional response, Decreased attention and memory
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| Positive Symproms of Schizophrenia | Delusions (paranoia), Hallucinations (voices), Thought disorder (feeling of external control), Abnormal behaviors (occasionally aggressive – self-abuse / self-mutilation), Anxiety and depression
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| Which Type of Schizophreniz Symptoms Tend to Show First? | Negative Symptoms
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| Suicide occurs in about ___% of Schizophrenia cases | 10%
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| First successful Schizophrenia treatment | Thorazine (Chlorpromazine) – used to deworm cattle originally
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| Thorazine (Chlorpromazine) Mechanism | Inhibits receptors for Serotonin, Histamine, Norepinephrine, Dopamine and ACh
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| Neurotransmitters possibly responsible for Schizophrenia | Increased Serotonin, but that causes Increased Dopamine, but that causes Decreased Glutamate
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| Which drugs are they moving toward to treat Schizophrenia? | Glutamate Receptor Agonists (mGlu2/3 Receptor Agonists)
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| Why are Glutamate Agonists better than traditional Schizophrenia medications? | They reduce both positive and negative symptoms but have no extrapyrimidal symproms, no sedation/weight gain, no hypotension, no adverse effects because they ONLY affect Glutamate receptors, not Serotonin receptors
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| Which receptor do all antipsychotic drugs block? | Dopamine Receptors (D2)
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| Antipsychotic drugs may also block: | Serotonin, Histamine, Norepinephrine, ACh
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| Behavioral Effects of Antipsychotic Drugs | Reduced emotion, initiative, and aggression, but no confusion or loss of intellectual function
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| Common Side Effects of Antipsychotic Drugs: | 1. ExtraPyramidal Effects (due to antagonism of Dopamine [D2] receptors – causes Dystonias, Dyskenesias, Catalepsy) 2. Sedation and weight gain (due to antagonism of Histamine receptors) 3. Hypotension (due to antagonism of NE receptors)
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| ExtraPyramidal Effects of Antipsychotic Drugs are Due To: | Antagonism of Dopamine (D2) Receptors
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| Dystonias | Slow, painful, twisting movements (one of the EPEs)
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| Dyskinesias | Rapid, brief, jerky movements (one of the EPEs)
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| Catalepsy | Trance-like state, pose-able limbs (one of the EPEs)
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| Sedation and Weight Gain Effects of Antipsychotic Drugs are Due To: | Antagonism of Histamine Receptors
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| Hypotension Effect of Antipsychotic Drugs is Due To: | Antagonism of NE Receptors
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| “Typical Antipsychotic” Drugs (Classical) | Thorazine (Chlorpromazine) and Haldol (Halopieridol)
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| Effects of “Typical Antipsychotic” Drugs (Classical) | Reduce positive symptoms, but no effect on negative symptoms
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| “Atypical Antipsychotics” (Modern) | Risperdol (Risperidone), Zyprexa (Olanzapine), Seroquel (Quetiapine)
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| Effects of “Atypical Antipsychotic” Drugs (Modern) | Reduce BOTH positive and negative symptoms
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| What percent of patients do not respond to antipsychotic drugs? | 30%
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| LSD stimulates the release of which NT? | Serotonin (LSD users exhibit Schizophrenic traits)
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| Amphetamines stimulate the release of which NT? | Dopamine (Amphetamine users exhibit Schizophrenic traits)
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| PCP inhibits which receptors? | Glutamate [NMDA] Receptors (PCP users exhibit Schizophrenic traits)
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| High Serotonin can stimulate _______ Dopamine | High
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| High Dopamine can _______ Glutamate | Decrease
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| Types of Affective Disorders | Unipolar Depression, Manic, Bipolar Depression (Manic-Depressive)
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| Characteristics of Unipolar Depression | Excessive misery, pessimism, inadequacy
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| Characteristics of Manic Disorder | Excessive exuberance, enthusiasm, self-confidence
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| Characteristics of Bipolar Depression (Manic-Depressive) | Chronic swinging between manic and depressive
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| Manic Disorder | Abnormally elevated mood and energy (a lot of emotion and activity)
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| Good Symptoms of Manic Disorder: | Excessive exuberance, enthusiasm, self-confidence
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| Bad Symptoms of Manic Disorder: | Irritability, aggressiveness, poor judgment (moving toward things in an irrational way)
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| Manic Disorder rarely occurs without periodic ________ | Depression
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| Bipolar Depression (Manic-Depressive Disorder) | Chronic swinging between manic and depressive states; usually manifests in late adolescence
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| Bipolar Depression (Manic-Depressive Disorder) affects ___% of U.S. population | 1%
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| Bipolar Depression (Manic-Depressive Disorder) is caused by: | Thyroid abnormalities (common), Vitamin B12 deficiency, Epilepsy, Medications (steroids, stimulants)
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| When does Bipolar Depression (Manic-Depressive Disorder) usually manifest? | In late adolescence
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| Specific Bipolar Depression Drugs | Lithium and Depakote (Divalproex)
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| How does Lithium work to treat Bipolar Depression? | Increases Serotonin release, Increases Glutamate reuptake
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| How does Depakote (Divalproex) work to treat Bipolar Depression? | May increase GABA concentrations, Decreases neuronal activity
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| Additional Therapies for Bipolar Depression | Antiepileptic drugs, Antianxiety drugs (Benzodiazepines), Antipsychotic drugs, Antidepressants
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| How do antiepileptic drugs treat Bipolar Depression? | Decrease neuronal activity
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| How do antianxiety drugs treat Bipolar Depression? | Decrease neuronal activity (Benzodiazepines)
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| Depression affects approximately ___% of Americans over 18 years old | 15%
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| Mortality rate of untreated Depression | 15%
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| Biological causes of Depression: | Possibly due to impaired neurogenesis in Hippocampus (important for memory and emotions) which is one of the few areas of post-natal neurogenesis; Stress impairs hippocampal neurogenesis, therefore stressful childhood can impair hippocampal neurogenesis
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| Emotional Symptoms of Depression | Misery, apathy, pessimism, low self-esteem, guilt, inadequacy, indecisiveness, loss of motivation
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| Biological Symptoms of Depression | Impaired thought and action, Sleep disturbance, Loss of libido and appetite
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| Reuptake Transporters | Transport NTs from synapse back into presynaptic terminal
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| MonoAmine Oxidase (MAO) | Enzyme inside presynaptic neuron that inactivates NTs
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| MonoAmine Theory of Depression | Depressed patients have low MonoAmines in CSF (Drugs that decrease MonoAmines cause Depression and drugs that increase MonoAmines relieve Depression)
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| Three Classes of Antidepressants: | 1. MonoAmine Oxidase Inhibitors (MAOIs) 2. MonoAmine Reuptake Inhibitors 3. “Au Natural”
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| MonoAmine Oxidase Inhibitors (MAOIs) are used to: | Alleviate Depression
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| Downside of using MAOIs for Depression: | Cuase side effects because all MAOs are inhibited; Sudden cessation causes nausea and vomiting
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| How many MAOIs in the Top 200? | None
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| Types of MonoAmine Reuptake Inhibitors: | Non-Selecive Serotonin/Norepinephrine Reuptake Inhibitors (NRI), Selective Serotonin Reuptake Inhibitors (SSRI), Selective Norepinephrine Reuptake Inhibitors (SNRI), Dopamine Uptake Inhibitor (DUI)
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| NRI stands for: | Non-Selective Serotonin/Norepinephrine Reuptake Inhibitor
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| SSRI stands for: | Selective Serotonin Reuptake Inhibitor
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| SNRI stands for: | Selective Norepinephrine Reuptake Inhibitor
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| DUI stands for: | Dopamine Uptake Inhibitor
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| NRI Drugs | Effexor (Venlafaxine), Elavil (Amitriptyline), Pamelor (Nortriptyline)
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| Which two NRIs are tricyclic? | Amitriptyline and Nortriptyline
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| SSRI Drugs | Zoloft (Sertraline), Prozac (Fluoxetine), Paxil (Paroxetine), Celexa (Citalopram), Lexapro (Escitalopram), Deseryl (Trazodone)
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| No SSRIs are 100% selective: some still inhibit ________ and _________ reuptake | Dopamine and Norepinephrine
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| SNRI Drugs | None in Top 200
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| DUI Drugs | Wellbutrin (Buproprion)
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| All Anti-Depression drugs lead to side effects because they also exhibit some antagonism of | ACh, NE, and Histamine receptors
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| “Au Natural” Products to Treat Depresion | L-Tryptophan and St. John’s Wort
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| How does L-Tryptophan treat Depression? | It is a precurser to Serotonin, but it has limited antidepressant action
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| How does St. John’s Wort treat Depression? | It contains Hyperforin which is a MonoAmine Transport Inhibitor that has confirmed antidepressant action
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| Good thing about St. John’s Wort? | Few side effects
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| Bad thing about St. John’s Wort? | Increases metabolism of Coumadin, Digoxin, Hormonal contraceptives, and others
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| Post-Pharmacologic Therapy for Depression | Electroconvulsive Therapy (most effective for severe suicidal depression)
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| Efficacy of Electroconvulsive Therapy for Depression | 60-80%
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| Electroconvulsive Therapy is most effective for what kind of depression? | Sever suicidal depression
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| Side Effect of Electroconvulsive Therapy | Confusion and Memory loss (days or weeks)
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