Psychosis and Antipsychotic Medications

Vocabulary practice flashcards covering definitions, symptomatic domains, clinical diagnostic criteria, extrapyramidal side effects, and antipsychotic classification based on lecture notes.

Psychosis

Disruptions to a person's thoughts and perceptions that make it difficult to recognize what is real and what isn't.

DSM-5 Psychotic Domains

The five symptomatic domains used to define abnormalities in psychosis: delusions, hallucinations, disorganized thoughts/speech, disorganized or abnormal behaviour, and negative symptoms.

Brief Psychotic Disorder

A primary psychotic disorder characterized by psychotic symptoms lasting less than $1$ month.

Schizophreniform Disorder

A primary psychotic disorder characterized by psychotic symptoms lasting between $1$ to $6$ months.

Schizophrenia

A primary psychotic disorder with symptoms lasting longer than $6$ months that affect level of functioning and cannot be attributed to substance use or another diagnosis.

Schizoaffective Disorder

A primary psychotic disorder characterized by psychosis occurring alongside a mood disorder.

Secondary Psychosis

Psychosis that occurs as a product of an underlying medical problem, such as illness, dementia/delirium, medications, or toxins.

Positive Symptoms

Psychotic symptoms that add features that are not normally present, including hallucinations, disorganized thinking, and delusions.

Negative Symptoms

Psychotic symptoms characterized by loss or withdrawal of normal functioning, such as alogia, flat affect, avolition, anhedonia, and loss of social interest.

Alogia

Poverty of speech, classified as a negative symptom of psychosis.

Avolition

Loss of motivation, classified as a negative symptom of psychosis.

Anhedonia

Lack of pleasure, classified as a negative symptom of psychosis.

Delusions

False, fixed beliefs that are unlikely to change despite contradictory evidence.

Hallucinations

Perceptions that occur without an external stimulus, with auditory hallucinations occurring in greater than $50\%$ of cases.

Catatonia

A form of disorganized behavior characterized by stupor, waxy flexibility, and stereotypy.

First Generation (Typical) Antipsychotics

Least expensive antipsychotic medications administered PO or IM to treat positive symptoms, carrying a higher risk for extrapyramidal side effects.

Second Generation (Atypical) Antipsychotics

More potent and expensive antipsychotics (PO, IM, oral dissolvable) treating positive and negative symptoms with lower EPS risk, but causing potential weight gain, metabolic syndrome, agranulocytosis, and dyslipidemia.

Third Generation Antipsychotics

The most expensive antipsychotics available in PO and longer-acting IM formulations, used for mood disorders and schizophrenia with lower EPS risk than 1st and 2nd generation.

Acute Dystonia

An extrapyramidal side effect occurring within hours to days, presenting with cramping, sustained muscle spasms, oculogyric crisis, and torticollis; treated with benztropine or diphenhydramine.

Oculogyric Crisis

A symptom of acute dystonia characterized by a spasm of the eyeballs in a fixed position.

Akathisia

An extrapyramidal side effect occurring within days, characterized by restlessness and fidgetiness; treated with propranolol, benzodiazepines, or benztropine.

Parkinsonism

An extrapyramidal side effect occurring within weeks to months, featuring cog-wheel muscle rigidity, masked facies, shuffling gait, and resting tremor; treated by lowering antipsychotic dosage or using benztropine/diphenhydramine.

Tardive Dyskinesia

A generally irreversible extrapyramidal side effect occurring over months, marked by involuntary lower facial movements (grimacing, tongue protrusion, lip smacking) and lower extremity twisting/tapping.

Neuroleptic Malignant Syndrome

A potentially life-threatening complication of antipsychotic treatment causing renal, heart, and lung failure; managed by stopping antipsychotics, IV fluids, dantrolene, and bromocriptine.

Psychosis Severity Continuum

A spectrum illustrating the progression from absence of psychosis to mild, moderate, and severe levels of psychotic manifestation.

Age Group Onset of Psychosis

A graphic comparison of onset percentages across age groups for males ($n=117$) and females ($n=131$), highlighting peak onset periods.

Extrapyramidal Side Effects Overview Table

A reference table listing onset timeframes, specific presentation symptoms, and recommended treatments for acute dystonia, akathisia, parkinsonism, and tardive dyskinesia.

Antipsychotic Drug Categories Table

A detailed chart outlining first-generation, second-generation, third-generation antipsychotic agents, and adjunct medications used for managing side effects.