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Creado por Bhavi Mistry
hace más de 11 años
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Pregunta | Respuesta |
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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