Schizophrenia & Psychosis

Psychosis vs schizophrenia

Local perspectives/stats

Diagnoses with associated psychotic symptoms

Etiology of schizophrenia

Primary pathophysiological abnormality may occur in one of various neurotransmitters

e.g. dysregulation of dopaminergic (DA), serotonergic (5HT) and glutamatergic functions

Others: e.g. PG, NA, GABA, Cyclic nucleopeptides, Somatostatin, other neuropeptides

Etiology of schizophrenia - Factors implicated in Genesis & Course of Schizophrenia

Etiology of schizophrenia - genetics

Etiology of schizophrenia - CAT scans and MRI studies

Clinical presentation - DSM-5 Criteria for Schizophrenia:

Clinical presentation - general assessment

Non-pharm management

Dopamine Pathways - Antipsychotic Effects

Dopamine Pathways - receptor affinities and clinical implications

Dopamine Pathways - Hypothetical Thresholds for Antipsychotic Drug Effects: D2 receptor blockade

Pharm management - therapeutic goals

Pharm management - antipsychotics

Pharm management - Antipsychotics for schizophrenia

Pharm management - Treatment algorithm for schizophrenia

Pharm management - Antipsychotic Selection

Pharm management - Precautions to antipsychotic use

Pharm management - adjunctive treatment

Pharm management - PK of antipsychotics

Pharm management - Dosing of oral antipsychotics

Pharm management - Dosing of IM long-acting antipsychotics (LAI)

Pharm management - SE of antipsychotics

SE of antipsychotics - management of serious SE

SE of antipsychotics - management of common SE

SE of antipsychotics - monitoring

Special populations - caution & specialist consultations

antipsychotics drug interactions - PD

antipsychotics drug interactions - PK

Please refer to Lecture Notes on Depression

Phase I Reactions: Oxidation, Reduction, Hydrolysis

Large family of isozymes (Cytochrome P450: CYP 1A2, 3A4, etc.)

Phase II Reactions: Coupling (e.g. glucuronidation)

antipsychotics drug interactions - CYP interactions

antipsychotics drug interactions - Clinically Significant Interactions with Antipsychotics

Evaluation of therapeutic outcomes