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Created by Bhavi Mistry
over 12 years ago
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| Question | Answer |
| Aripiprazole | Partial D2R agonist 5HT1 and 2c partial agonist No full blown side effects |
| Clozipine | Atypical antipsychotic (2nd generation) 5HT2 and Partial D2R antagonism Fewer EPS |
| 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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