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Exam 5 - Lecture 6

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