Neurophysiology in SCHIZOPHRENIA
reduced brain volume: enlarged lateral and third ventricles
limbic system decreases in size
prefrontal cortex is dyfunctional
shrinkage of the hypothalamus!
Elevated activity of D2 receptors is associated with _ symptoms in Schizophrenia
positive = better prognosis
what neurotransmitter levels have low activity in schizophrenia
GABA and NMDA (receptor hypo function)
what neurotransmitters are involved in the neurophysiology of schizophrenia
dopamine
serotonin
norepinephrine
GABA
NMDA
glutamate
PCP studies have been found to reduce _ function in schizophrenia
glutamate
what is the A category of the DSM-5 criteria for schizophrenia ?
two or more of the following for most of 1 month and at least one of the first three symptoms
delusions
hallucinations
disorganized speech
grossly disorganized or catatonic behavior
negative symptoms
what is the B category in the DSM5 criteria for Schizophrenia
marked social or occupational dysfunction
what is category C of the DSM 5 criteria of Schizophrenia
duration of at least 6 months of persistent symptoms such as attenuated forms of group A above or negative symptoms at least one moth must include a group A symptom
what is category D of the DSM-5 criteria for Schizophrenia
symptoms of schizoaffective and mood disorder are ruled out
what is category E of the DSM 5 criteria for Schizophrenia
substance abuse and medical conditions are ruled out as etiologic
risk factors for being violent with schizophrenia
antisocial/borderline personality disorder
history of violent acts
paranoid beliefs
content of auditory hallucinations
substance abuse
impulsivity
talking about violence
_ is the single leading cause of death in Schizophrenia patients
suicide
_ may reduce suicide rates in schizophrenia
clozapine
what are the 5 diagnostic criteria for Schizophrenia Catatonic Type (only need 2/5)
- motor immobility as evidenced by catalepsy or stupor
- excessive motor activity
- extreme negativism or mutism
- weird voluntary movement such as posturing, prominent mannerisms or prominent grimacing
- Echolalia or Echopraxia
how can we treat Schizophrenia ?
hospitalize them
group therapy
psychotherapy
community treatment
self-help programs
medication
Electroconvulsive therapy
Benzodiazepines for catatonic disorder
how do we treat acute psychosis in schizophrenia ?
IM injections of haloperidol, fluphenazine. olanzapine, choropromazine
how do you treat the stabilization phase of Schizophrenia ?
newer atypical antipsychotics
how do you treat the maintenance phase of schizophrenia ?
long acting depot injections
keep patients free from symptoms while avoiding incapacitating effects
poor responders are _ in patients whose SCHIZOPHRENIA was once under control but no longer responds
relapses
there is noncompliance with medication
first generation antipsychotics block _ receptors
dopamine
what are the first generation antipsychotics? (6)
Haloperidol
Loxapine
Pimozide
Chlopromazine
Perphenazine
Thiothixene
what are the side effects of first generation antipsychotics ?
extrapyramidal syndromes (EPSs)
neuroleptic malignant syndrome
what is extrapyramidal syndrome?
acute dystonic reactions - contractions of the mouth, eyes, and face
drug induced Parkinsonism- cogwheel rigidity, bradykinesia, tremor
antipsychotic induced catatonia- inability to speak
tardive dyskinesia- fasciculation’s of the tongue, lingual-facial hyperkinesis
akathisia- motor restlessness, inability to keep legs and feet still
what is neuroleptic malignant syndrome
muscular rigidity , fever, autonomic instability, altered level of consiousness
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Pharmacology of CNS Stimulants- Iszard44
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Clinical Approach to Neurodevelopmental Disorders94
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Gender and Sexuality-Schmidt57
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Clinical Approach to Eating Disorder and Refeeding Syndrome74
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Schizophrenia38
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Antidepressants and Mood stabilizers99
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Clinical Approach to Trauma28
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Approach to Psychosomatic Disorders57
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Antipsychotics- Segars51
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pharmacology of opioids52
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substance abuse43
