CHP. 12 - ANTIPSYCHOTICS

separation between though, emotion, and behavior in a single personality

traits that are abnormally present in psychosis -

hallucinations, delusions, irrational beliefs, feelings of grandeur, paranoia

traits abnormally absent in psychosis

affective flattening - person's face is immobile ad unresponsive; emotional repression

anhedonia - which a person feels no pleasure

avolition - inability to initiate or engage in goal-directed activites

Lateral and Third Ventricles - nearly 2x as large compared to normal brain

Brain Tissue Volume - reduced grey matter (corpus colosum, frontal temporal lobes, cerbellum, hippocampus, mesolymbic area

Synaptic Pruning - weak unused synapses are pruned out and strong ones grow stronger; exaggerated too many connections are pruned

Schizophrenia and other psychoses result from excessive dopamine activity in the brain

too much dopamine in the mesolymbic pathrway; too little in mesocortical

glutomate is underactive; too mch at NDMA receptors, too little at AMPA receptors

genetic factors predispose individual to glutomate hyperactivity, specifically at the NDMA receptor -- man of the genes contributed to the development of schizophrenia

facial ticks, twitching in muscles, lip smacking, tongue flicking

permanent, irreversible

dulled facial expression,rigid limbs, slowing in movements, loss of coordination

60-80%

block d1 and d2

high affinity for d2 and 5-HT2A

side effects: EPS

bind to D2 receptors loosely and have dissociiation constants that are significantly higher than typicals

block D3 and D4, low affinity (bind) for 5TH-2A

side effects: metabolism, weight issues

3rd generation

DA; partial

modulates; blocks; D2; D3; D4

binding to; increasing; too high

administration: orally, intramuscular

absorption: first pass metabolism, binds to fats and proteins in blood; slow release, slow excretion

• typical half life = 28 days
• a-typical half life = 2-4 days

competitive with other drugs at cp450

movement disorders, oversensitivity to sunlight, weight gain, changes in HR, dry mouth, impaired vision, dizziness, increased triglycerides and cholesterol, constipation, jaundice, increased risk of seizure, sedation

weight gain, increased risk of diabetes, increased triglycerides, dry mouth, dizziness, nausea, cataracts, sedation, sleep apnea

do not effect REM sleep, high TI

NO PLEASANT EFFECTS

feelings of tiredness, slower and confused thinking, difficulty concentrating, clumsiness, anxiety irritability, internally awake but not externally tired

cognitive deficits related to sedating effects; tolerance can be built

fertility issues, decreased libido, impaired performance, lactation leakage, abnormal menstrual cycles

blocks nausea, helps with motion sickness,

• treats:
• hiccups, monoamine induced psychosis, irritability in autistic children