Neuropsychology

Somatic Nervous System and Autonomic Nervous System

Contractions of the heart muscle

Changes in electrical conductance of the skin.

Prepares the body for "fight or flight"

Relaxes the body; deactivates "flight or fight"

• 1. Primitive core
• 2. Limbic system (old brain)
• 3. Cerebral cortex/cerebrum (new brain)

Regulate basic somatic activities

Mediate basic drives and emotions.

Responsible for higher-level cognitive, emotional, and motor functions

A condition in which both lower limbs are paralyzed; results from a cut above the point where nerves innervating the lower body enter and exit

The paralysis of all four limbs; results from cut at the top of the spinal cord

Paralysis in an arm and leg on one side of the body; caused by a partial cut of the spinal cord

Slight or partial paralysis; results from spinal cord damage

Abnormal sensations such as numbness, tingling, or burning; results from spinal cord damage

Abnormal sensitivity to sensation; results from spinal cord damage

Cell body (soma), dendrite, axon

Respond to stimulation from other neurons and carry information to the cell body

To carry information away from the cell body

The impulse "spike" fired by a neuron

A neuron either reaches the charge necessary for action potential or does not; a higher charge does not change the intensity of the action potential

Diameter of the neuron and the amount of myelin sheathing

Synapse

Neurotransmitters

Cell body (soma)

In the terminal buttons of the neuron, in pockets called vesticles

Reuptake and enzymatic degredation

Terminal buttons take up excess neurotransmitter and store it for later use

Enzymes in and around the synapse break down neurotransmitters

• 1. Movement
• 2. Learning and memory
• 3. Sexual behavior
• 4. Sleep

Alzheimer's disease

Norepinephrine, epinephrine, and dopamine

Depression

Schizophrenia

Dopamine

Depression, OCD, PTSD, and aggression

Schizophrenia, anorexia, and autism

Anxiety and Parkinson's Disease

Huntington's Chorea

• 1. dementia
• 2. involuntary jerky movements in the arms and legs

Glutamate

Inhibit/block feelings of pain by binding to opiate receptor sites

Brain and spinal cord

Hindbrain, midbrain, and forebrain

Controls breathing, heart rate, blood pressure, digestion

Death

In the brain stem, within the hindbrain area

Brain stem and cerebellum

Regulates arousal

It uses serotonin and associated with slow wave sleep

In the brain stem, within the hindbrain

Controls balance, movement, and posture

In the hindbrain

Ataxia

Slurred speech, severe tremors, loss of balance

Controls aspects of movement, including smoothness, initiation, termination, and directness

Parkinson's disease

In the midbrain

• 1. Sleep, arousal, and attention
• 2. Sensations of pain and touch
• 3. Control of reflexes

Filter information

In the midbrain

Disruption in the sleep-wake cycle; permanent coma-like sleep state

• 1. Maintain homeostasis
• 2. Control motivated behavior
• 3. Translate feelings into physical responses

• 1. Autonomic nervous system
• 2. Endocrine system

In the hypothalamus

Control of circadian rhythms

In the forebrain

Eating or drinking can be disrupted.

It serves as the "central switching station," relays all sensory information (except olfaction) to the cortex

In the forebrain

Thalamus

A B1 deficiency, that usually occurs in alcoholics, that produces amnesia, confabulation, and apathy

Codes and relays information associated with voluntary movement.

In the forebrain

• 1. Tourette's Syndrome
• 2. Parkinson's Disease
• 3. Huntington's Chorea

To mediate the emotional component of behavior

• 1. Amygdala
• 2. Septum
• 3. Hippocampus

• 1. Integrate and direct emotional behavior
• 2. Attach emotional significance to information
• 3. Mediate aggressive/defensive behavior

Lack of emotional response

The amygdala

A pattern of behavior observed in monkeys with damage to the amygdala. It is characterized by reduced fear and aggression, increased docility, altered dietary habits, and hypersexuality

In the limbic system

Inhibits emotionality (pleasure center)

In the limbic system

Septal-rage syndrome

• 1. Hyperemotionality
• 2. Vicious behavior

Septum

Memory, including consolidation and transfer from short- to long-term memory

Severe, permanent anterograde amnesia?

The inability to form new memories

In the limbic system

Hemispheres

It means that the left side of the brain controls the right side of the body and vice versa.

• 1. Frontal lobe
• 2. Occipital lobe
• 3. Temporal lobe
• 4. Parietal lobe

They are controlled to a greater extent by one hemisphere of the brain

Sperry

Split-brain refers to a condition where an individual's corpus callosum is severed. It results in an inability for the two hemispheres of the brain to communicate.

The bundle of fibers that attaches the left and right hemispheres of the brain

Logical abilities; language

Emotion, creativity, spatial relationships, facial recognition

Increased EEG activity on the right side of the brain for spatial tasks, and increased EEG activity on the left side of the brain for verbal tasks

Depression and anxiety

Apathy or indifference

• 1. Motor behavior
• 2. Expressive lanuage
• 3. Higher-order cognitive processes (and orientation)

• 1. Frontal lobe personality
• 2. Psychopathic syndrome

A psuedodepression characterized by apathy, lack of drive, little verbal output, and inability to plan/focus

Pseudopsychopathy characterized by sexual inhibition, coarse language, peculiar and facetious sense of humor, inappropriate social behavior, and lack of concern for others

• 1. Motor cortex
• 2. Premotor cortex
• 3. Prefrontal cortex

Control of voluntary movement

• 1. Contralateral motor weakness
• 2. Paralysis
• 3. Apraxia

Loss of ability to execute or carry out purposeful movements

Simulation of actions (imagery and observation)

In the premotor cortex within the (usually left) frontal lobe of the brain

Speech production

Broca's (expressive) aphasia, which involves slow speaking or speaking with great difficulty

A disturbance of comprehension and production of language

• 1. Personality
• 2. Emotion
• 3. Memory
• 4. Executive functioning

• 1. ADHD
• 2. Schizophrenia
• 3. Bipolar disorder
• 4. Age-related cognitive declines

• 1. Receptive lanuage
• 2. Memory
• 3. Emotion

Temporal lobe

Inability to recognize or differentiate between sounds

Amnesia (retrograde or anterograde) and conduction aphasia

Inability to repeat what is heard

In the temporal lobe

Comprehension of language

• 1. Wernicke's aphasia, which is production of speech that sounds normal, but makes little sense
• 2. Dysnomia, which is the inability to name familiar objects

The pathway between Broca's and Wernicke's area called the arcuate fasciculus

• 1. Touch-pressure
• 2. Temperature
• 3. Kinesthesia
• 4. Pain

Awareness of the position and movement of body parts

Parietal lobe

Loss of interest in or awareness of one side of the body

Inability to identify objects by touch

Inability to recognize body parts

Inability to recognize functional impairments

Inability to write

In the parietal lobe

Process somatosensory input and integrate it with other sensory information

• 1. Insensitivity to touch
• 2. Disruption of movement

Parietal

• 1. Agraphia
• 2. Acalculia
• 3. Right-left confusion
• 4. Finger agnosia

Inability to distinguish, name, or recognize the fingers

Difficulty performing simple mathematical tasks

Vision

Occipital lobe

Occipital lobe

Inability to recognize familiar objects by sight

Mediate fine movement

Motor movement

• 1. Cerebellum
• 2. Basal ganglia
• 3. Substantia nigra

Basal ganglia

• 1. Produce GABA
• 2. Controls muscular activities

The amount of dopamine increases because GABA regulates the amount of dopamine in the brain through an inhibitory process

Huntington's Chorea

The fibers connecting Broca's and Weirnicke's area

• 1. They are connected to our earliest experiences and physiological drives
• 2. They are universal
• 3. They are not under conscious control

Emotions occur when people experience arousal and interpret them as an emotional state (e.g., I am afraid because I tremble)

Emotions are a result of simultaneous stimulation of the thalamus and the cortex; arousal and feeling occur at the same time

Emotion is related to arousal and our attributions for that arousal based on environmental cues

Schachter and Singer

In a variety of cultures, facial expressions reflected innate emotions

• 1. Fear
• 2. Anger
• 3. Joy
• 4. Sadness
• 5. Surprise
• 6. Disgust

Hypothalamus

• 1. Lateral hypothalamus
• 2. Ventromedial hypothalamus

Failure to eat and drink

Failure to drink

Overeating and increased body weight

It receives information from the GI tract and transmits it to the hypothalamus

Emotive properties of food, such as reward and pleasure sensations

25-40%

People who are obese overeat due to being inherently more sensitive to external rather than internal cues

• 1. Pituitary gland
• 2. Gonads (ovaries and testes)

It produces sex hormone hormones.

They receive hormones produced by the pituitary gland and then produce androgens and estrogen (ovaries produce progesterone as well).

Progesterone

Follicle stimulating hormone (FSH)

They are the primarily male sex hormone; They cause the development of secondary sex characteristics in males and are involved in sexual interest in both males and females

The function is unknown.

It is necessary for normal sexual development and functioning of the reproductive system.

Healthy functioning of the reproductive system

All three

Menopause

• 1. Osteoporosis
• 2. Heart disease

Breast cancer

Androgens

A condition in males in which the circulating levels of androgens are low

Androgen replacement therapy

Ejaculation

Stages 1-4

Alpha waves give way to theta waves

Theta waves with intermittent bursts of activity

Delta

• 1. Deep breathing
• 2. Slowed heart rate
• 3. Low blood pressure

It is more difficult to wake them

A combination of relaxation and activity

• 1. Rapid eye movement
• 2. Loss of muscle tone

Relaxed wakefulness

Active, alert state

100

4-6 times

Shorter; longer

REM

Two, REM and non-REM

50; 20

• 1. Increased anxiety/irritability
• 2. Decreased cognitive functioning

People who have been deprived from REM sleep will spend more time in REM when their sleeping returns to normal.

They disappear

• 1. Less delta sleep
• 2. More movement during sleep
• 3. More changes in the sleep cycle

REM sleep

Stage 4

• 1. Synaptic membrane
• 2. RNA (ribonucleic acid)

High frequency stimulation of neurons in the hippocampus lead to increased sensitivity and results in change of shape of synapses and the formation of new receptors

He extracted RNA from flatworms who had learned a conditioned response and then injected it into other flatworms. The new flatworms learned the conditioned response more quickly.

RNA

Hypothalamus

Pituitary gland; it secretes hormones that causes other glands to release hormones as well as secretes hormones that act directly on organs

Pituitary gland

Giantism

Dwarfism

Acromegaly

Grossly enlarged hands, feet, and facial features

Cortisol

It elevates it

To stimulate growth by acting on plates at the end of bones

It stimulates the liver to convert glucose to energy

Addison's disease

Fatigue, fainting, loss of appetite, decreased weight, depression, and apathy

Cushing's disease

Obesity, memory loss, mood swings, depression, and somatic delusions

• 1. Relaxation training
• 2. Biofeedback

It will fail to develop male genitalia

It will develop male reproductive organs.

Lowered sexual potency

Thyroxine

Controls metabolism

Cretinism

• 1. Physical maldevelopment
• 2. Intellectual impairment

Hypothyroidism

Slowed metabolism, reduced appetite, weight gain, lowered heart rate and temperature, decreased libido, depression, and cognitive deficits

Hyperthyroidism (also known as Grave's Disease)

Elevated heart rate and temperature, increased metabolism, weight loss, nervousness, agitation, fatigue, insomnia, mania, and decreased attention

Pancreas

Helps the body to absorb and make use of glucose and amino acids

Diabetes

Mineral loss, low blood pressure, reduced blood flow, and death

Hypoglycemia

Hunger, dizziness, headaches, blurred vision, anxiety, depression, and confusion

Vision

• 1. Taste
• 2. Smell

• 1. Movement
• 2. Hearing
• 3. Touch

Hot and cold

Cornea, pupil, lens, retina

The transparent covering in front of the eye

Regulate the amount of entering light through opening and closing

Focus light waves on the retina

Retina

Inner lining of the eyeball

Rods and cones

Photoreceptors that sense stimuli in low light

Photoreceptors that specialize in seeing color and function only in daylight

Periphery

Center

An area in the center of the retina that has a high concentration of photoreceptors and as a result, is the region of maximum visual acuity

It carries nerve impulses from the retina to the brain.

A "blind spot"

Other; same

Right

The thalamus, and then the visual cortex in the occipital lobe

Eardrum

Membrane in the ear that vibrates as a function of sound waves

The ossicles (three bones)

Oval window

Cochlea

Liquid in the inner ear

Hair cells

They serve as auditory receptors and transform mechanical vibrations to neural activity

• 1. Auditory nerve
• 2. Thalamus
• 3. Auditory cortex in the temporal lobe

The stimulus that excites the auditory system

Frequency, amplitude, and timbre

Hertz

Decibel

The ability to orient toward the direction of a sound by turning one's head

It declines

At 12 months of age

• 1. Touch/pressure
• 2. Body position (kinesthesia)
• 3. Temperature
• 4. Pain

• 1. Knowledge
• 2. Attention
• 3. Motivation
• 4. Suggestibility

• 1. Depression develops as a result of chronic pain
• 2. Chronic pain is a type of masked depression ("pain prone" individuals)

• 1. Depressive disorders
• 2. Alcohol dependence

When the large, myelinated fibers that transmit information to the brain are activated, it "closes the gate" which makes the small, unmyelinated fibers unable to transmit pain signals as well. The pain mediation system can only process a limited amount of information.

• 1. Massage
• 2. Heat or cold
• 3. Information traveling to the brain, such an engaging in a distracting mental activity

• 1. Opium
• 2. Morphine
• 3. Heroin

They bind to opiate-specific receptors

They line the olfactory epithelium in the rear of the nasal passages

This mechanism is unknown

Olfactory sensations are transmitted directly through the brain through the limbic system, while other senses are relayed through the thalamus

Left

• 1. Initiate sexual activity
• 2. Mark territory

• 1. Sweet
• 2. Sour
• 3. Bitter
• 4. Salty

In the taste buds in the papillae (bumps) n the surface of the tongue

Infancy

The study of the relationship between the magnitude of physical stimuli and psychological sensations

The weakest stimulus that a person can detect

The smallest difference between two stimuli that is recognized as a difference

• 1. JNDs are psychologically equal intervals
• 2. Changes in the magnitude of a physical stimuli are logarithmically related to changes in internal sensations

There is an exponential relationship between the magnitude of physical stimuli and internal sensations, with the exponent varying for different kinds of stimuli

Smell

Information going to the brain

Information coming from the brain

• 1. CAT (Computerized Axial Tomography)/CT scan
• 2. MRI (Magnetic Resonance Imaging)

X-rays; magnetic fields

• 1. It is superior in detecting fresh blood
• 2. It is less expensive

• 1. It produces 3D images of the brain
• 2. It provides more precise detail
• 3. It does not use x-rays

• 1. PET (Positron Emission Tomography) scan
• 2. SPECT (Single Photon Emission Computer Tomography)
• 3. fMRI (Functional Magnetic Resonance Imaging)

• 1. Regional cerebral blood flow
• 2. Glucose metabolism
• 3. Oxygen activity

Problems in articulation that are due to lesions or diseases that disrupt the control of speech

• 1. Parkinson's Disease
• 2. Huntington's Chorea
• 3. Multiple Sclerosis

A reading disability caused by an acquired brain lesion

The inability to carry out a command to perform a particular movement. Individuals who suffer from this may be able to perform that movement spontaneously, however.

The inability to draw or copy simple figures or to arrange blocks in a pattern

Visual distortion that prevents recognition of an object

The inability to recognize an object by sight, but can recognize it kinesthetically when placed in the hand

Disconnection of the visual and language areas of the brain

An inability to name an object but ability to demonstrate its use and match it with similar objects

The inability to recognize familiar faces

Hemiplegia

A stroke affecting the right parietal cortex

• 1. Patients with CN are inattentive to everything on one side of the body, while patients with anosognosia are unaware of only functional limitations
• 2. Patients with CN will acknowledge neglected area if their attention is directed to it, while patients with anosognosia will continue to deny it

• 1. Brain stem
• 2. Cerebellum

Cerebral cortex

Psychological symptoms, such as depression or anxiety

• 1. Headaches
• 2. Seizures
• 3. Nausea and vomiting
• 4. Changes in vision and hearing
• 5. Other focal neurological signs (e.g., ataxia, localized weakness)

Cerebrovascular accident

The onset of neurological symptoms caused by a sudden, severe interference of blood flow to the brain

The middle cerebral artery

• 1. Contralateral hemiplegia and sensory loss, especially in face and arms
• 2. Dementia
• 3. Contralateral visual field loss (homonymous hemianopsia)

Contralateral visual field loss

• 1. Contralateral hemiplegia and sensory loss
• 2. Dementia
• 3. Affective disturbance

• 1. Cortical blindness and other visual deficits
• 2. Anterograde amnesia
• 3. Agitated delirium

Excessive accumulation of cerebrospinal fluid within the ventricles of the brain

• 1. Dementia
• 2. Gait disturbance
• 3. Urinary incontinence

50

10%

In the first 6 months

Physical; cognitive

Head trauma

An head injury in which the skull is penetrated

They are usually focal in nature and resolve relatively rapidly

In an open head injury, people don't generally lose consciousness, while in a closed head injury, loss of consciousness is more common

Closed

The duration of anterograde amnesia

6-9 months

A disorder included in the DSM-IV under conditions provided for further study. The criteria include a concussion following head trauma and three or more of the following symptoms: fatigue, headache, dizziness, irritability/aggression, and depression or anxiety

50

30-50 years old

Affective

Slow, writhing movements

Involuntary rapid, jerky movements of the face, limbs, and trunk

Younger

• 1. Substantia nigra
• 2. Basal ganglia
• 3. Cortex

• 1. Glutamate
• 2. Acetylcholine
• 3. GABA
• 4. Dopamine

A degenerative brain disorder characterized by abnormalities in movement

• 1. Tremor
• 2. Muscle rigidity
• 3. Involuntary movements
• 4. Disturbance in posture and equilibrium
• 5. Akinesia

Inability to initiate movement

40%

• 1. Serotonin (reduced levels)
• 2. Dopamine (degeneration of dopamine-producing cells)

Drugs that increase levels of dopamine in the brain, including L-dopa

Functional techniques

Inhibitory

Hypothesis that depression is due to a deficiency of norepinephrine

The formation of new neurons or nerve cells neurons added to the brain in maturity.

• 1. Olfactory system
• 2. Hippocampus
• 3. Cerebral corex (prefrontal, inferior temporal, and posterior parietal regions)

Any consistent differences between males and females in size and shape.

A rare condition in which stimulating one sense creates a sensation in another sense, such as tasting a color

Most effects occur after 2 weeks, but it can take up to 6 weeks.

They block the reuptake of norepinephrine and serotonin

Tricyclic antidepressants

Vegitative symptoms

• 1. panic attacks
• 2. agoraphobia
• 3. obsessive states
• 4. chronic pain
• 5. bulimia
• 6. enuresis

Dry mouth, constipation, urinary retention, blurred vision, nasal congestion

• 1. Anticholinergic
• 2. GI symptoms
• 3. Impaired sexual functioning
• 4. Skin rash
• 5. Sedation
• 6. Memory impairments (especially in elderly)
• 7. Confusion
• 8. Insomnia
• 9. Cardiovascular (tachycardia, palpitations, changes in blood pressure

Severe hypotension, fever, delirium, seizure, coma, or sudden death due to cardiac arrhythmia

Patients who have heart disease or are suicidal

Severe convulsions, hyptertensive crisis, and death

They increase the availability of serotonin at the synapse by inhibiting its reuptake

Imipramine

Clomipramine

Amitriptyline

Doxepin

Tricyclic antidepressants

SSRI antidepressants

Fluoxetine

Sertraline

Paroxetine

Fluvoxamine

Citalopram

Escitalopram

• 1. OCD
• 2. Binge eating
• 3. Panic disorder
• 4. Anxiety

• 1. fewer side effects
• 2. Relatively safe in overdose
• 3. No anticholinergic effects
• 4. No cognitive impairment

• 1. GI problems
• 2. Loss of appetite
• 3. Decreased libido and other sexual dysfunction
• 4. Dizziness
• 5. Headache
• 6. Worsened sleep and anxiety problems

Serotonin syndrome

• 1. Cognitive: headaches, agitation, hypomania, confusion, hallucinations, coma
• 2. Autonomic: shivering, sweating, hyperthermia, hypertension, tachycardia, nausea, diarrhea
• 3. Somatic: muscle twitching, tremor, hyperreflexia

Children and adolescents

2004

Fluoxetine

They block the action of enzymes that break down norepinephrine and serotonin leading to increased availability of these neurotransmitters in the brain

MAOIs

Tranylcypromine

Phenelzine

Atypical, with symptoms such as increased appetite, hypersomnia, rejection-sensitivity, mood reactivity, symptom increase as day progresses, and accompanying symptoms of phobic anxiety, panic, and/or hypochondriasis

• 1. hypotension
• 2. dizziness
• 3. dry mouth
• 4. upset stomach
• 5. weight gain
• 6. blurred vision
• 7. headache

Potentially fatal hypertensive crisis, with elevated blood pressure and convulsions

Drowsiness or agitation, hypertension, tachycardia, hallucinations, delusions, seizures, and coma; a large overdose can be fatal

They block the reuptake of norepinephrine and serotonin, leading to increased availability of these neurotransmitters

• 1. Panic disorder
• 2. Generalized anxiety
• 3. Social anxiety

Vanlafaxine

Duloxetine

Desvenlafaxine

• 1. Lower risk associated with overdose
• 2. More rapid onset

• 1. abnormal dreams
• 2. agitation
• 3. sexual dysfunction
• 4. GI problems
• 5. blood pressure changes
• 6. drowsiness
• 7. tingling sensations
• 8. trembling

A chemical that binds to a receptor and triggers a response

A chemical that binds to a receptor and blocks other chemicals from binding to it

SARI antidepressants

It serves as an antagonist and inhibits the reuptake of serotonin

Trazodone

Nefazadone

• 1. Blurred vision
• 2. Drowsiness

Insomnia

• 1. Dizziness
• 2. Nausea
• 3. Headache
• 4. Sedation

Impotence

• 1. Orthostatic hypertension
• 2. Priapism

A long-lasting, painful erection

Tetracyclic antidepressants

Mirtazipine

Maprotiline

As a noradrenaline and selective serotonin antidepressant and an antihistamine

By increasing norepinephrine and serotonin in the brain

• Sedation, skin rash, blurred vision, dry mouth,
• dizziness, agitation, irritability and weight gain

Sexual dysfunction

• 1. Depression with anxiety
• 2. Depression with sleep problems
• 3. Chronic pain

Bupropion

Burpropion

• 1. Smoking cessation
• 2. Distractibility due to ADHD (off-label)

Seizures; psychosis

abdominal pain, constipation, decrease in appetite, dizziness, dry mouth, increased sweating, nausea, trembling, difficulty sleeping, unusual dreams

Norepinephrine reuptake inhibitors

Reboxetine

Atomoxetine

Noradrenaline reuptake inhibitor

• 1. ADHD (only non-stimulant medication approved for this disorder)
• 2. Anxiety (off-label)

• 1. Lithium
• 2. Anticonvulsants

Reducing postsynaptic responsivity to dopamine and norepinephrine

Lithium

• 1. Reduces/eliminates manic symptoms
• 2. Levels out mood swings

• 1. schizophrenia
• 2. intermittent explosive disorder
• 3. epilepsy
• 4. episodic binge drinking

GI distress, weight gain, tremor (mostly in fingers; 35% of those taking), fatigue, and mild cognitive impairment

Toxicity can result from too high dosage and lead to symptoms such as vomiting, abdominal pain, profuse diarrhea, severe tremor, and ataxia and can led to seizures, coma, or death

Mania, especially dysphoric or rapid cycling

Serotonin

Fewer side effects

Anti-convulsants

Carbamazapine

Lamotrigine

Topimarate

Valproic acid

agranulocytosis

Decrease in certain types of white blood cells

Faster onset of action

Lethargy, tremor, ataxia, and visual disturbance

Neuroleptics

Neuroleptic malignant syndrome

Muscle rigidity, high fever, sweating, stupor, unstable blood pressure, altered mental status, and autonomic dysfunction

Within the first 2 weeks

Death (NMS has a very rapid onset)

By blocking dopamine receptors in the brain

The dopamine hypothesis is the belief that schizophrenia is a result of overactivity of dopamine. This hypothesis came about after observation that dopamine elevating drugs (such as amphetamine) can lead to psychotic symptoms in individuals without a history and can worsen symptoms in those who have previously had psychosis. Currently, it is believed that schizophrenia's mechanism is more complicated and may involve imbalance of dopamine and involve serotonin and norepinephrine as well.

Traditional antipsychotics

Chlorpromazine

Haloperidol

Thioridiazine

Fluphenazine

• 1. Schizophrenia
• 2. Acute mania
• 3. Psychotic symptoms of other disorders

Positive

Symptoms that most non-schizophrenic individuals do not experience, such as delusions, hallucinations, agitation, disordered thoughts and speech

Deficits in normal emotional or cognitive processes, including anhedonia, flat affect, poverty of speech, lack of desire to form relationships, and lack of motivation

• 1. Anticholinergic
• 2. Extrapyramidal

• 1. Parkinsonism
• 2. Akathesia
• 3. Dystonia
• 4. Tardive dyskensia

Muscle stiffness, shuffling gait, stooped posture, slurred speech, mask-like facial expression

A syndrome associated with muscular discomfort and extreme restlessness

sustained muscle contractions or spasms resulting in involuntary movements

A syndrome associated with abnormal involuntary movements, especially of the face, tongue, and jaw

After 6 months

They can be alleviated (especially in younger patients), but there may be an aggravation of symptoms before they decrease

Dopamine, serotonin, and glutamate

Atypical antipsychotics

Clozapine

Risperidone

Olanzapine

Arpiprazole

• 1. Schizophrenia
• 2. Disorders with psychotic symptoms
• 3. Motor symptoms of movement disorders

Faster onset

Treatment of both positive and negative symptoms

Agranulocytosis, higher rate of seizures, anticholinergic effects, sedation, hypotension

• 1. Anti-convulsants
• 2. Atypical antipsychotics

Benzodiazepines

They enhance the activity of GABA, which has an inhibitory effect on the central nervous system

Benzodiazepines

Diazepam

Clonazepam

Alprazolam

Lorazepam

Traizolam

• 1. Anxiety
• 2. Insomnia
• 3. Severe alcohol withdrawal
• 4. Cerebral palsy
• 5. Petit mal/absence seizures

Anterograde amnesia

Confusion and disorientation that are sometimes mistaken for dementia

Drowsiness, sedation, weight gain, apathy, dry mouth, GI distress, paradoxical excitation, motor disturbances, and sexual dysfunction

Addiction, including tolerance and severe withdrawal symptoms

Irritability, anxiety, agitation, insomnia, tremor, abdominal cramps, muscle cramps, vomiting, sweating, flu-like symptoms

Seizures, stroke, panic and rebound hypterexcitability

Death

They interrupt impulses to the reticular activating system

They have been replaced by benzodiazepines, which are safer to use

Barbiturates

Thiopental

Amobarbital

Secobarbital

Convulsive seizures and death

Barbiturates

Fatal suppression of respiration

Since alcohol and barbiturates have a potentiating effect on brain structures that control breathing, mixing them can be lethal

Azapirone

Buspirone

By enhancing the activity of dopamine and noradrenaline and reducing serotonin and acetylcholine

• 1. It reduces anxiety without sedative effect or anticonvulsant, or muscle relaxant effects
• 2. It is not addictive or habit-forming

Slower onset

Dizziness, nausea, headache, nervousness, lightheadedness, and excitement

Beta blocker

They reduce the activity of beta-adrenergic neurons, which innervate the cardiovascular and respiratory systems and reduce heart rate and hyperventilation

Propanolol

• 1. Hypertension
• 2. Cardiac arrhytmias
• 3. Migraine
• 4. Essential tremor
• 5. Anxiety, especially in performance situations like public speaking

Fine to moderate tremor that runs in families

Bradychardia, hypotension, sexual dysfunction, fatigue, parasthesia, and depression

Increased heart rate

Slowed heart rate

Sensation of tingling, burning, prickling, tickling, or pricking of a person's skin

More likely to cause memory impairment

Sweating, palpitations, headache, and tremors

Quick; short to medium

Hypnotics

Insomnia

Unpleasant taste, headache, dry mouth, heartburn, drowsiness

They innervate the central nervous system by mimicking or potentiating the action of catecholamines in the brain

Cocaine and amphetamines

Psychostimulants

Lisdexamfetamine

Methylphenidate

Pemoline

Dextroamphetamine

Amphetamine salts

• 1. ADHD
• 2. Narcolepsy

Decreased appetite, insomnia, stomach aches, dysphoria; OCD symptoms may occur; can exacerbate tics and trigger psychotic episode

Dextroamphetamine

By taking "drug holidays"

Bind to enkephalin receptors in the CNS and block transmission of neural impulses

Opium, morphine, codeine

Heroin, percodan, demerol, methodone

Heroin detoxification

Withdrawal effects are milder, duration of effects are longer, and has oral administration

Partial opiods

Opiod addiction; they can produce opiate agonist effects (maximal effects are less than full agonists, though) that can prevent side effects in opiate withdrawal

Euphoria, respiratory depression, nausea, vomiting, and constipation

Pre-op medication to induce relaxation and sedation, acute pain, chronic pain

Pupil constriction, decreased visual activity, perspiration, GI distress, and respiratory depression

Decreased pulse, resulting in convulsions, and leading to coma or death

They are addictive and produce tolerance and severe withdrawal symptoms

Alcohol dependence

Disulfram

Naltrexone

Acamprosate calcium

Blocks the processing of alcohol in the body, thus causing an unpleasant reaction when alcohol is consumed

Severe nausea

It is an opiod receptor antagonist

Increases GABA levels

Poverty of speech

Lack of motivation

Mesencephalon

The tectum and the tegmentum

Substantia nigra

Inferior colliculus

Superior colliculus

Forebrain

Visual hallucinations of terrifying faces

• 1. Eye opening
• 2. Best motor response
• 3. Best verbal response

The function of the brain's activating center

Ability to move arms and legs

Condition of the central nervous system within the cerebral cortex

One

• 1. mild
• 2. moderate
• 3. severe

Eight levels of cognitive functioning

In acute rehabilitative settings following release from intensive care

After injury occurs or as pre-hospital information

Iif someone is alert, responds to voice, responds to pain or is unresponsive

General level of disability from “none” to “extreme vegetative state.”

Slow-cautious

Quick-impulsive

Cognitive regulation and planning (e.g., executive functioning)

Parietal lobe

Temporal lobe

Parts of the temporal lobe and hippocampus

Long-term memory

Prefrontal cortex

Memories which can be consciously recalled, such as facts and knowledge

• 1. Episodic
• 2. Semantic

Memory for specific personal experiences

Memory for factual information

Explicit

A type of memory in which previous experience aids in the performance of a task without conscious awareness of these activities

Implicit memory for the performance of specific types of tasks, those that reside below the level of conscious awareness (e.g., tying shoes)

Declarative/explicit memory, with episodic memory being more affected than semantic memory

• 1. Cervical
• 2. Thoracic
• 3. Lumbar
• 4. Sacral

Back of the head, the neck, shoulders, arms, hands, and diaphragm

The torso and parts of the arms

Hips, thighs, and legs

Groin, toes, and some parts of the legs

The parietal lobe; it includes the somatosensory cortex

Numbness in contralateral hand and contralateral neglect

Motor functioning