What are the two main groups of antipsychotic medications?
1. First generation (older)
2. Second generation (er)
What is the dopamine hypothesis of schizophrenia?
Blocking dopamine correlates with time course of behavioral effects
What is the serotonin hypothesis of schizophrenia?
Many atypical antipsychotics are potent 5-HT2C receptor antagonists/inverse agonists.
- 5HT2A (5HT2C) activity activity modulates the release of several neurotransmitters
Side effects of antipsychotics come from binding....
- Alpha adrenoreceptors
- Muscarinic receptors
- H1 histamine reseptors
At >80% occupancy of D2 receptors by typical antipsychotics ____ can occur.
Extra pyramidal side effects
T/F: Most antipsychotics have no active metabolites.
False; They typically have one or more active metabolites
Side effects from blocking muscarinic receptors?
- Dry mouth
- Loss of accommodation
- Difficulty urinating
- Toxic confusional state
Side effects from blocking alpha- adrenergic receptors?
- Orthostatic hypotension
- Failure to ejaculate
Side effects from blocking dopamine receptors?
- Parkinson's syndrome
- Hyperprolactinemia (except aripiprazole)
What should be done if a patient develops tardive dyskinesia?
Switch therapy to quetiapine or clozapine
What are signs/symptoms of neuroleptic malignant syndrome
Severe case of Parkinsonism
- Extreme muscle rigidity
- Very high fever
- Autonomic instability
-Elevated muscle type creatine kinase levels
Effects of hyperprolactinemia?
- Breast enlargement
- Amenorrhea and osteoporosis in women
- Sexual dysfunction and infertility in men
Other side effects of antipsychotics...
- Retinal deposits
- Deposits in the cornea and lens
- QT prolongation
Treatment options for Bipolar Disorder...
- Anticonvulsants (Valproate, Carbamazepine)
- Antipsychotics (Aripiprazole, Olanzapine, Ziprasidone)
Inhibits the rate limiting enzyme in inositol recycling, and this depletes PIP2 and second messangers