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LUMC Antipsychotics

Psychiatry Clerkship Neuroleptic Notes

QuestionAnswer
Dopamine Hypothesis of Schizophrenia Hyperdopaminergic pathways: responsible for the positive symptoms Hypodopaminergic pathways: responsible for the negative symptoms
Dopamine Pathways Nigrostriatal tract, Mesolimbic tract, Mesocortical tract, Tuberoinfundibular tract
Nigrostriatal tract Substantia nigra (midbrain) to corpus striatum (extrapyrimidal tract) (PART OF EXTRAPYRAMIDAL SYSTEM)
Mesolimbic tract Midbrain (VTA) to limbic structures (POSITIVE SYMPTOMS)
Mesocortical tract Midbrain (VTA) to the prefrontal cortex (NEGATIVE SYMPTOMS)
Tuberoinfundibular tract Arcuate nucleus to median eminence (INHIBITS PROLACTIN SYNTHESIS)
Dopamine Hypothesis of Schizophrenia Hyperdopaminergic pathways: responsible for the positive symptoms Hypodopaminergic pathways: responsible for the negative symptoms
Dopamine Pathways Nigrostriatal tract, Mesolimbic tract, Mesocortical tract, Tuberoinfundibular tract
Nigrostriatal tract Substantia nigra (midbrain) to corpus striatum (extrapyrimidal tract) (PART OF EXTRAPYRAMIDAL SYSTEM)
Mesolimbic tract Midbrain (VTA) to limbic structures (POSITIVE SYMPTOMS)
Mesocortical tract Midbrain (VTA) to the prefrontal cortex (NEGATIVE SYMPTOMS)
Tuberoinfundibular tract Arcuate nucleus to median eminence (INHIBITS PROLACTIN SYNTHESIS)
Typical Antipsychotics: Chlorpromazine, Trifluperazine depot, Loxitane, Molindone, Pimozide, Haloperidol depot
Atypical Antipsychotics: Clozapine, Risperidone depot, Quietapine, Olanzapine, Ziprasidone, Aripiprazole
Antipsychotics - Indications - Psychotic do's: schizophrenia, delusional do, schizoaffective do, brief reactive psychosis - Mood Disorders w/ psychotic features - Agitated delirium/dementia w/ psychosis - Tourette's
Antipsychotics - General MOA - Both typical & atypical agents block central post-synaptic DA receptor activity
Typical Antipsychotics - MOA Block Dopamine receptors as well as H1, Muscarinic, & a2 adrenergic
Atypical Antipsychotics - MOA Block Serotonin in addition to DA receptors which eliminates EPS/prolactin release --> better SE profile
Dopamine Receptors - D1, D5 Receptors: couple to Gs --> activates Adenylyl Cyclase - D2, D3, D4 Receptors: couple to Gi --> inhibit adenylyl cyclase *D2 antagonists likely best for treating psychosis
Created by: dsilver2
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