Schizophrenia: Clinical Pharmacology and Personalised Medicine

Vocabulary practice flashcards covering diagnostic categories, clinical symptoms, neurochemical hypotheses, dopaminergic pathways, adverse events, and pharmacological treatments for schizophrenia based on Professor Jerome Swinny's lecture.

Neuroses

Mental illnesses characterized by emotional distress without losing touch with reality, encompassing anxiety disorders (such as panic attacks, generalized anxiety disorder, and PTSD) and affective disorders (such as major depression and bipolar disorder).

Psychoses

Mental health disorders characterized by a loss of contact with or disconnection from reality, of which schizophrenia is the most common form.

Schizophrenia

The most common form of psychosis, wherein patients oscillate between normal and abnormal mental states; it is characterized by a loss of contact with reality and disruption of thought, cognition, perception, mood, and movement.

Positive symptoms of schizophrenia

Psychotic manifestations that represent an excess or distortion of normal function, specifically delusions, hallucinations, disorganised speech, and grossly disorganized or catatonic behaviour.

Negative symptoms of schizophrenia

Deficits reflecting a loss of normal functioning, including reduced expression of emotion, poverty of speech, difficulty in initiating goal-directed movements, and cognitive or memory impairment.

Paranoid schizophrenia

A subtype of schizophrenia in which delusions and hallucinations are present, while thought disorder, disorganized behaviour, and mood flattening are absent.

Disorganised schizophrenia

A subtype of schizophrenia characterized by the presence of thought disorder and mood flattening.

Catatonic schizophrenia

A subtype of schizophrenia in which the patient exhibits agitated, purposeless movement.

Postpartum psychosis

A psychotic condition defined by the postpartum onset of psychotic episodes.

DLPC

Dorsolateral prefrontal cortex

Mesocorticolimbic dopamine system

A dopaminergic pathway originating in the ventral tegmental area (VTA) that innervates the frontal cortex and limbic system, implicated in reward, motivation, and psychiatric disorders.

Nigrostriatal pathway

A dopamine pathway projecting from the substantia nigra (SN) to the striatum that facilitates the initiation and coordination of voluntary movements.

Tuberohypophyseal system

A neuroendocrine dopaminergic pathway connecting arcuate and paraventricular neurons to the hypothalamus and pituitary gland, where dopamine physiologically inhibits prolactin secretion.

Dopamine hypothesis of schizophrenia

A neurochemical theory postulating that the symptoms of schizophrenia result from excess dopaminergic neurotransmission, particularly within mesolimbic and striatal brain regions.

Homovanillic acid

A major metabolite of dopamine whose levels change following successful therapeutic treatment of patients with schizophrenia.

Glutamatergic hypothesis of schizophrenia

A theory proposing that hypofunction of NMDA receptors on GABAergic interneurons reduces inhibition onto principal glutamatergic cells, leading to excessive glutamatergic activity and hyperactivation of dopamine-expressing neurons.

TrkB neurotrophin receptor

A neurotrophin receptor whose deficient signaling leads to reduced GABA synthesis and cell death in the parvalbumin-containing subpopulation of inhibitory GABA neurons in the DLPFC.

GABAergic hypothesis of schizophrenia

A pathophysiological model proposing that the loss or dysfunction of parvalbumin-expressing inhibitory interneurons reduces GABA synthesis, disinhibiting excitatory pyramidal neurons and ultimately elevating dopamine release.

First-generation ('typical') antipsychotics

Traditional antipsychotic medications (e.g., chlorpromazine, haloperidol, fluphenazine, flupenthixol, clopenthixol) that primarily act via strong $D_2$ dopamine receptor blockade and carry a higher risk of extrapyramidal side effects.

Second-generation ('atypical') antipsychotics

Antipsychotics (e.g., clozapine, risperidone, olanzapine, quetiapine, aripiprazole) characterized by distinct receptor profiles, lower incidence of extrapyramidal symptoms, efficacy against negative symptoms, and efficacy in treatment-resistant cases.

Acute dystonia

An early-onset extrapyramidal motor reaction caused by dopamine receptor blockade in the nigrostriatal pathway, manifesting as parkinsonian movements and typically being reversible.

Tardive dyskinesia

A late-onset, debilitating, and often irreversible extrapyramidal adverse effect caused by dopamine receptor supersensitivity, marked by involuntary, repetitive movements.

Cobenfy

A novel antipsychotic combining xanomeline and trospium that exclusively targets cholinergic muscarinic receptors to alleviate positive, negative, and cognitive symptoms of schizophrenia.

Xanomeline

A central-acting drug component of Cobenfy that activates muscarinic acetylcholine receptors within the brain.

Trospium

A peripheral muscarinic receptor antagonist component of Cobenfy that blocks the activation of peripheral muscarinic receptors to prevent peripheral side effects.