CHAPTER 12 (drugs and behaviour)

Schizophrenia

Severe psychotic disorder involving disturbances in thought, perception, emotion, and behaviour.

Psychotic Disorders

Disorders characterized by impaired reality testing (delusions, hallucinations, disorganized thought).

Delusions

Fixed, irrational beliefs held despite contradictory evidence.

Hallucinations

Perceptual experiences occurring without external sensory input.

Disorganized Thinking (Speech)

Disrupted, illogical speech that impairs communication.

Grossly Disorganized or Abnormal Motor Behaviour

Difficulty performing goal-directed activities; behaviour may be inappropriate or erratic.

Negative Symptoms

Reduction or absence of normal emotional, behavioural, and social functioning.

Persecutory Delusions

Belief of being targeted, harmed, or conspired against.

Grandiose Delusions

Belief of having exceptional abilities, power, or importance.

Religious Delusions

Delusions involving religious themes or identities.

Auditory Hallucinations

Hearing voices or sounds (most common).

Visual Hallucinations

Seeing objects or figures that are not present.

Disorganized Speech

Speech reflecting disordered thinking.

Loosening of Associations

Shifting between unrelated ideas.

Incoherence

Speech that is illogical or difficult to follow.

Word Salad

Completely disorganized, incomprehensible speech.

Grossly Disorganized Behaviour

Inability to perform daily activities appropriately.

Random Agitation

Unpredictable, excessive motor activity.

Childlike Silliness

Inappropriate, immature behaviour.

Catatonia

Spectrum of abnormal motor behaviours.

Catatonic Stupor

Immobility, mutism, and minimal response to the environment.

Catatonic Excitement

Excessive, frenzied, repetitive motor activity.

Echolalia

Repetition of another person's speech.

Neurodevelopmental Disorder

Disorder arising from abnormal brain development due to genetic and environmental factors.

Dopamine Hypothesis

Positive symptoms are caused by excessive dopamine activity.

Mesolimbic Pathway

Dopamine pathway linked to positive symptoms when overactive.

D2 Receptors

Dopamine receptors blocked by antipsychotic drugs.

Limitation of Dopamine Hypothesis

Does not adequately explain negative or cognitive symptoms.

Glutamate Dysfunction

Reduced glutamate activity contributing to schizophrenia symptoms.

Mesocortical Pathway

Dopamine pathway linked to negative and cognitive symptoms when underactive.

Ketamine & PCP

Drugs that induce schizophrenia-like symptoms, supporting glutamate involvement.

Serendipity

Accidental discovery of therapeutic drug effects.

Henri Laborit

French surgeon who discovered chlorpromazine's psychiatric effects.

Surgical Shock

Dangerous drop in vital functions during surgery.

Chlorpromazine

First antipsychotic drug discovered.

Artificial Hibernation

Sedated but conscious state caused by chlorpromazine.

Thorazine

U.S. trade name for chlorpromazine.

Laragactil

European trade name for chlorpromazine.

Deinstitutionalization

Large reduction in mental hospital populations due to antipsychotics.

Typical Antipsychotics

First-generation drugs that strongly block D2 receptors.

Phenothiazines

Class of typical antipsychotics (e.g., chlorpromazine).

Butyrophenones

Class of typical antipsychotics (e.g., haloperidol).

Extrapyramidal Symptoms (EPS)

Motor side effects such as tremor and rigidity.

Atypical Antipsychotics

Second-generation drugs with weaker D2 blockade and serotonin antagonism.

5-HT2A Receptors

Serotonin receptors blocked by atypical antipsychotics.

Clozapine

Atypical antipsychotic effective but requires blood monitoring.

Aripiprazole (Abilify)

Third-generation antipsychotic acting as a partial D2 agonist.

Partial Agonist

Drug that activates a receptor but produces a weaker response than the neurotransmitter.

Pharmacokinetics

How a drug is absorbed, distributed, metabolized, and excreted.

Blood-Brain Barrier

Barrier antipsychotics cross easily to reach the brain.

Protein Binding

Attachment of drugs to blood proteins, slowing release.

Cytochrome P450 Enzymes

Liver enzymes responsible for drug metabolism.

Half-Life

Time required for drug concentration to decrease by half.

Steady State

Point at which drug intake equals drug elimination.

Positive Symptoms

Hallucinations and delusions treated effectively by antipsychotics.

Cognitive Symptoms

Thinking and attention deficits modestly improved by atypicals.

Tardive Dyskinesia

Involuntary facial movements after long-term use.

Neuroleptic Malignant Syndrome (NMS)

Life-threatening reaction with fever and autonomic instability.

Hyperprolactinemia

Elevated prolactin levels caused by dopamine blockade.

Metabolic Syndrome

Weight gain and increased risk of type II diabetes.

QT Interval Prolongation

Delayed heart repolarization.

Agranulocytosis

Dangerous reduction in white blood cells.

Tolerance

Reduced response to some drug effects over time.

Sedation Tolerance

Decreased sedative effects with prolonged use.

Withdrawal

Usually mild or absent with antipsychotics.