Antipsychotics

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under grad Neuro-pharmacology Flashcards on Antipsychotics, created by Bhavi Mistry on 17/04/2013.
Bhavi Mistry
Flashcards by Bhavi Mistry, updated more than 1 year ago
Bhavi Mistry
Created by Bhavi Mistry over 11 years ago
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Question Answer
Clozipine Atypical antipsychotic (2nd generation) 5HT2 and Partial D2R antagonism Fewer EPS
Aripiprazole Partial D2R agonist 5HT1 and 2c partial agonist No full blown side effects
Positive symptoms Dellusions Hallucinations
Negative symptoms Anhedonia Loss of motivation Attention impairment
Cognition New learning Memory Executive function
Mood Depression Anxiety Impulse control
Dopamine theory Hyperdopaminergic function For: efficacy of D2Receptor blockade is inversely proportional to D2R efficacy Against: No change in prolactin
5HT-DA theory 5HT influences DA pathways (5HT2ARs)
LSD Powerful 5HT2A agonist -> hallucinations
5HT Regulates DA release Raphe -> cell bodies Raphe ->DAergic terminals
Glutamate theory Disease of hypoglutaminergic function NMDA antagonists enhance psychotic symptoms (e.g. Ketamine) Mutation of neuregulin-1 (plasticity, memory)
5HT2 antagonists Reduce effects of NMDA antagonists at VTA
NMDA antagonists Decrease burst firing of VTA DA neurons Increased firing of DA limbic areas Increased exrtacellular levels of 5HT (PFC)
5HT 2a antagonists restore dopaminergic function in the PFC
Mesolimbic pathway Emotion, reward VTA --> NAcc, Amygdala D2R inhibition reduces positive symptoms
Mesocortical pathway VTA --> cortical areas D2R inhibiton reduces DA in the cortex and precipitates negative symptoms + cognitive deficits
Nigrostriatal Pathways Substantia nigra --> striatum D2R inhibition leads to parkinson like (motor) side-effects if 80% are antagonised
Tuberoinfundibular pathway Hypothalamus --> pituitary D2R inhibition --> hyponatraemia
Haloperidol Typical antipsychotic (1st generation) D2R blockade Good effect on positive sumptoms, but many side effects. Adaptive changes are greatest in the mesolimbic pathway
D2R Side effects: Extrapyramidal (EPS), Prolactin inrease
M1 antagonism cognitive deficits, dry mouth, Constipation, Increased HR, urinary retention, blurred vision
Alpha1 antagonism Hypotension
5HT2A antagonism Anti EPS
5HT2C antagonism Satiety blockade (atypical drug --> weight gain)
DA blockade in nigrostriatal pathway Parkinsonism Acute dystonia Akathisia Tardive dyskinesia
Chlorpromazine Typical (1st generation) D1, D2, Alpha one, Histamine, MAChR antagonism
Fluphenazine Typical Antipsychotic (1st generation) Dopamine blockade
Thioridazine Typical antipsychotic DA blockade Cardiotoxicity
Pimozide Extremely strong: D2 Strong: D3, α1-adrenergic, 5-HT2A Moderate: D1, D4, α2-adrenergic Weak: mACh, H1 Extremely weak: 5-HT1A
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