9 - Antipsychotics and Lithium

Definition of psychosis

Loss of reality perception

Core symptoms of psychosis

Delusions, hallucinations

Types of delusions

Grandiose, bizarre, non-bizarre, mood-congruent, mood-incongruent

Definition of hallucinations

False sensory perceptions

Schizophrenia symptom categories

Positive, negative

Positive symptoms of schizophrenia

Delusions, hallucinations, disorganized speech

Negative symptoms of schizophrenia

Flattened affect, reduced speech, lack of initiative

Neurotransmitters implicated in schizophrenia

Dopamine, glutamate

Dopamine hypothesis of schizophrenia

D2 receptor overactivity

Effect of dopamine agonists on schizophrenia

Worsen symptoms

Mesolimbic pathway dysfunction

Positive symptoms

Mesocortical pathway dysfunction

Negative symptoms

Nigrostriatal pathway dysfunction

Movement disorders

Tuberoinfundibular pathway function

Prolactin inhibition

Parkinsonism symptoms

Rigidity, tremors, bradykinesia

Dystonia definition

Involuntary muscle contractions

Dyskinesia definition

Uncontrollable movements

Non-curative effect of antipsychotics

Reduce hallucinations, delusions

Primary mechanism of antipsychotics

Block dopamine (D2)

First-generation antipsychotics alternative names

Conventional, typical, traditional

First-gen antipsychotics mechanism

Block D2 receptors

Extrapyramidal symptoms examples

Tardive dyskinesia, akathisia, bradykinesia

Low-potency first-gen antipsychotics

Chlorpromazine, Thioridazine

High-potency first-gen antipsychotics

Fluphenazine, Loxapine, Haloperidol, Perphenazine, Pimozide, Prochlorperazine, Thiothixene, Trifluoperazine

Side effects of low-potency antipsychotics

Orthostatic hypotension, constipation, dry mouth, urinary retention, weight gain, sedation

Second-gen antipsychotics primary mechanism

Block serotonin receptors

Second-gen antipsychotics benefits

Better for negative symptoms, lower EPS risk

Second-gen antipsychotics drugs

Aripiprazole, Asenapine, Clozapine, Iloperidone, Lurasidone, Olanzapine, Paliperidone, Quetiapine, Risperidone, Ziprasidone

Clozapine and Olanzapine side effects

Weight gain, hyperglycemia, hyperlipidemia

Clozapine and Risperidone side effect

Orthostatic hypotension

Drugs blocking cholinergic receptors

Thioridazine, Chlorpromazine

Drugs blocking alpha-adrenergic receptors

Chlorpromazine

Drugs with high D2 blockade

Haloperidol, Fluphenazine, Thiothixene

Drugs blocking serotonin receptors

Risperidone, Clozapine

Drugs blocking histamine receptors

Chlorpromazine, Clozapine

Common antipsychotic ADRs

Urinary retention, weight gain, seizures, sedation, EPS, postural hypotension, sexual dysfunction, arrhythmias, dry mouth