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SchizoDepress
Exam 5 - Lecture 6
| Question | Answer |
|---|---|
| Types of Psychiatric Disorders | Neurotic Disorders, Psychotic Disorders, Mood/Affective Disorders, and Others (Personailty Disorders and Dissociative Disorders) |
| Neurotic Disorders are ________ thought/feeling involving a(n) _________ stimulus | Abnormal thought/feeling involving a Real stimulus |
| Psychotic Disorders are ________ thought/feeling involving a(n) _________ stimulus | Normal thought/feeling involving an Unreal stimulus |
| Mood/Affective Disorders are ________ emotional states that are ________ to a stimulus | Abnormal emotional states that are Irrelevant to a stimulus |
| Neurotic Disorders cause abnormal: | Stress (anxiety), Fear (phobia), Desire (fetish), Impulse (-mania) |
| Psychotic Disorders cause: | Delusion, Hallucination |
| Mood/Affective Disorders cause abnormal states of: | Sadness, Happiness, Irritability, Anger |
| Schizophrenia is what kind of disorder? | Psychotic |
| Depression is what kind of disorder? | Mood/Affective Disorder |
| Mania is what kind of disorder? | Mood/Affective Disorder |
| Bipolar is what kind of disorder? | Mood/Affective Disorder |
| Characteristics of a Personality Disorder | Mix of all three (neurotic, psychotic, and mood/affective) disorders but with relationship/social/cultural conflicts |
| Characteristics of a Dissociative Disorder | Any aspects of the three (neurotic, psychotic, or mood/affective) disorders but with loss of self-awareness |
| What is the most common psychotic disorder? | Schizophrenia |
| Schizophrenia | Most common psychotic disorder, means “split mind” (from reality), psychotic with social/occupational dysfunction |
| Schizophrenia affets about ___% of the U.S. population | 1% |
| Hereditary factor Schizophrenia is ___% for close relatives and ___% for identical twins | 10% for close relatives and 50% for identical twins |
| Neurodevelopmental factors associated with Schizophrenia | Thiamine deficiency? Virus? Maternal stress? Problems with neuron proliferation, neuron myelination, or neurotransmitter receptor expression |
| Clear Schizophrenia symptoms begin in __________ | Adolescence |
| Negative Symptoms of Schizophrenia | Withdrawal from social contacts, Flattening of emotional response, Decreased attention and memory |
| 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 |
| Which Type of Schizophreniz Symptoms Tend to Show First? | Negative Symptoms |
| Suicide occurs in about ___% of Schizophrenia cases | 10% |
| First successful Schizophrenia treatment | Thorazine (Chlorpromazine) – used to deworm cattle originally |
| Thorazine (Chlorpromazine) Mechanism | Inhibits receptors for Serotonin, Histamine, Norepinephrine, Dopamine and ACh |
| Neurotransmitters possibly responsible for Schizophrenia | Increased Serotonin, but that causes Increased Dopamine, but that causes Decreased Glutamate |
| Which drugs are they moving toward to treat Schizophrenia? | Glutamate Receptor Agonists (mGlu2/3 Receptor Agonists) |
| 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 |
| Which receptor do all antipsychotic drugs block? | Dopamine Receptors (D2) |
| Antipsychotic drugs may also block: | Serotonin, Histamine, Norepinephrine, ACh |
| Behavioral Effects of Antipsychotic Drugs | Reduced emotion, initiative, and aggression, but no confusion or loss of intellectual function |
| 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) |
| ExtraPyramidal Effects of Antipsychotic Drugs are Due To: | Antagonism of Dopamine (D2) Receptors |
| Dystonias | Slow, painful, twisting movements (one of the EPEs) |
| Dyskinesias | Rapid, brief, jerky movements (one of the EPEs) |
| Catalepsy | Trance-like state, pose-able limbs (one of the EPEs) |
| Sedation and Weight Gain Effects of Antipsychotic Drugs are Due To: | Antagonism of Histamine Receptors |
| Hypotension Effect of Antipsychotic Drugs is Due To: | Antagonism of NE Receptors |
| “Typical Antipsychotic” Drugs (Classical) | Thorazine (Chlorpromazine) and Haldol (Halopieridol) |
| Effects of “Typical Antipsychotic” Drugs (Classical) | Reduce positive symptoms, but no effect on negative symptoms |
| “Atypical Antipsychotics” (Modern) | Risperdol (Risperidone), Zyprexa (Olanzapine), Seroquel (Quetiapine) |
| Effects of “Atypical Antipsychotic” Drugs (Modern) | Reduce BOTH positive and negative symptoms |
| What percent of patients do not respond to antipsychotic drugs? | 30% |
| LSD stimulates the release of which NT? | Serotonin (LSD users exhibit Schizophrenic traits) |
| Amphetamines stimulate the release of which NT? | Dopamine (Amphetamine users exhibit Schizophrenic traits) |
| PCP inhibits which receptors? | Glutamate [NMDA] Receptors (PCP users exhibit Schizophrenic traits) |
| High Serotonin can stimulate _______ Dopamine | High |
| High Dopamine can _______ Glutamate | Decrease |
| Types of Affective Disorders | Unipolar Depression, Manic, Bipolar Depression (Manic-Depressive) |
| Characteristics of Unipolar Depression | Excessive misery, pessimism, inadequacy |
| Characteristics of Manic Disorder | Excessive exuberance, enthusiasm, self-confidence |
| Characteristics of Bipolar Depression (Manic-Depressive) | Chronic swinging between manic and depressive |
| Manic Disorder | Abnormally elevated mood and energy (a lot of emotion and activity) |
| Good Symptoms of Manic Disorder: | Excessive exuberance, enthusiasm, self-confidence |
| Bad Symptoms of Manic Disorder: | Irritability, aggressiveness, poor judgment (moving toward things in an irrational way) |
| Manic Disorder rarely occurs without periodic ________ | Depression |
| Bipolar Depression (Manic-Depressive Disorder) | Chronic swinging between manic and depressive states; usually manifests in late adolescence |
| Bipolar Depression (Manic-Depressive Disorder) affects ___% of U.S. population | 1% |
| Bipolar Depression (Manic-Depressive Disorder) is caused by: | Thyroid abnormalities (common), Vitamin B12 deficiency, Epilepsy, Medications (steroids, stimulants) |
| When does Bipolar Depression (Manic-Depressive Disorder) usually manifest? | In late adolescence |
| Specific Bipolar Depression Drugs | Lithium and Depakote (Divalproex) |
| How does Lithium work to treat Bipolar Depression? | Increases Serotonin release, Increases Glutamate reuptake |
| How does Depakote (Divalproex) work to treat Bipolar Depression? | May increase GABA concentrations, Decreases neuronal activity |
| Additional Therapies for Bipolar Depression | Antiepileptic drugs, Antianxiety drugs (Benzodiazepines), Antipsychotic drugs, Antidepressants |
| How do antiepileptic drugs treat Bipolar Depression? | Decrease neuronal activity |
| How do antianxiety drugs treat Bipolar Depression? | Decrease neuronal activity (Benzodiazepines) |
| Depression affects approximately ___% of Americans over 18 years old | 15% |
| Mortality rate of untreated Depression | 15% |
| 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 |
| Emotional Symptoms of Depression | Misery, apathy, pessimism, low self-esteem, guilt, inadequacy, indecisiveness, loss of motivation |
| Biological Symptoms of Depression | Impaired thought and action, Sleep disturbance, Loss of libido and appetite |
| Reuptake Transporters | Transport NTs from synapse back into presynaptic terminal |
| MonoAmine Oxidase (MAO) | Enzyme inside presynaptic neuron that inactivates NTs |
| MonoAmine Theory of Depression | Depressed patients have low MonoAmines in CSF (Drugs that decrease MonoAmines cause Depression and drugs that increase MonoAmines relieve Depression) |
| Three Classes of Antidepressants: | 1. MonoAmine Oxidase Inhibitors (MAOIs) 2. MonoAmine Reuptake Inhibitors 3. “Au Natural” |
| MonoAmine Oxidase Inhibitors (MAOIs) are used to: | Alleviate Depression |
| Downside of using MAOIs for Depression: | Cuase side effects because all MAOs are inhibited; Sudden cessation causes nausea and vomiting |
| How many MAOIs in the Top 200? | None |
| 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) |
| NRI stands for: | Non-Selective Serotonin/Norepinephrine Reuptake Inhibitor |
| SSRI stands for: | Selective Serotonin Reuptake Inhibitor |
| SNRI stands for: | Selective Norepinephrine Reuptake Inhibitor |
| DUI stands for: | Dopamine Uptake Inhibitor |
| NRI Drugs | Effexor (Venlafaxine), Elavil (Amitriptyline), Pamelor (Nortriptyline) |
| Which two NRIs are tricyclic? | Amitriptyline and Nortriptyline |
| SSRI Drugs | Zoloft (Sertraline), Prozac (Fluoxetine), Paxil (Paroxetine), Celexa (Citalopram), Lexapro (Escitalopram), Deseryl (Trazodone) |
| No SSRIs are 100% selective: some still inhibit ________ and _________ reuptake | Dopamine and Norepinephrine |
| SNRI Drugs | None in Top 200 |
| DUI Drugs | Wellbutrin (Buproprion) |
| All Anti-Depression drugs lead to side effects because they also exhibit some antagonism of | ACh, NE, and Histamine receptors |
| “Au Natural” Products to Treat Depresion | L-Tryptophan and St. John’s Wort |
| How does L-Tryptophan treat Depression? | It is a precurser to Serotonin, but it has limited antidepressant action |
| How does St. John’s Wort treat Depression? | It contains Hyperforin which is a MonoAmine Transport Inhibitor that has confirmed antidepressant action |
| Good thing about St. John’s Wort? | Few side effects |
| Bad thing about St. John’s Wort? | Increases metabolism of Coumadin, Digoxin, Hormonal contraceptives, and others |
| Post-Pharmacologic Therapy for Depression | Electroconvulsive Therapy (most effective for severe suicidal depression) |
| Efficacy of Electroconvulsive Therapy for Depression | 60-80% |
| Electroconvulsive Therapy is most effective for what kind of depression? | Sever suicidal depression |
| Side Effect of Electroconvulsive Therapy | Confusion and Memory loss (days or weeks) |
Created by:
Cyndi1087
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