lecture 1

• What is the repeated word in the study material?

  Silence
• What was the first medicine prescribed to Leslie Clark Goulet?

  Thorazine
• How did Thorazine affect Leslie Clark Goulet?

  It drugged her, making her unable to wake up
• How many different medications did Leslie try over 30 years?

  25 different medications
• What symptoms did Leslie experience during her illness?

  Anxiety, agitation, poor concentration
• What effect did some medications have on Leslie's ability to drive?

  They made her feel too drugged to drive
• What was Leslie's concern about changing medications?

  She feared losing her ability to care for Matt
• What did Leslie find familiar about some medications she took?

  They provided stability and familiar side effects
• What are the main receptor affinities of psychotropic drugs?

  • Antipsychotics
  • Antidepressants
  • Anxiolytics
  • Hypnotics
• What are common side effects of psychotropic drugs?

  • Unwanted receptor affinities
  • Varying effects based on drug type
• What is the main understanding of pathophysiology in mental disorders?

  It is derived from psychotropic drug actions
• What are potential mechanisms to alleviate major depressive disorder?

  • Antidepressants
  • Lifestyle changes (diet/exercise)
  • Psychotherapy
  • Social support
• How many prescriptions for antidepressants were recorded in 2018?

  70.9 million prescriptions
• How did the number of antidepressant prescriptions change from 2008 to 2018?

  It increased from 36 million to 70.9 million
• What neurotransmitters are involved in the brain's general scheme?

  • Dopamine
  • Noradrenaline
  • Serotonin (5-HT)
  • GABA
• What is the role of the nigrostriatal dopamine pathway?

  Initiation and control of movement
• What does the mesolimbic dopamine pathway influence?

  Reward and reinforcement
• What does the tubero-infundibular pathway inhibit?

  Release of prolactin hormone
• How is serotonin inactivated in the brain?

  By reuptake into the pre-synaptic neuron
• What is the role of GABA in the CNS?

  It stabilizes neurons by allowing chloride flux
• What is the prevalence of schizophrenia in the population?

  1% of the population
• What is a significant hereditary linkage in schizophrenia?

  60% - 80% heritability in identical twins
• What characterizes the positive symptoms of schizophrenia?

  Hallucinations, delusions, thought disorder
• What are first-rank symptoms of schizophrenia?

  Thought interference and delusions of control
• What accumulates over time in schizophrenia?

  Negative symptoms
• What can precede the onset of schizophrenia?

  An insidious prodromal state
• What environmental factors are associated with schizophrenia?

  Factors during brain development
• What is the dopamine hypothesis in schizophrenia?

  Dopamine underpins the development of schizophrenia
• How do antipsychotics affect dopamine receptors?

  They block post-synaptic dopamine receptors
• What is the effect of drugs that increase dopamine?

  They can cause psychosis
• What evidence supports the dopamine hypothesis?

  Elevated pre-synaptic dopamine synthesis
• What does reserpine do to dopamine transmission?

  It depletes dopamine transmission
• What do PET and SPECT scans show in schizophrenia?

  Increased brain dopamine activity
• Why do antipsychotics take time to work on symptoms?

  Neurotransmitter effects are immediate
• What neurotransmitters appear to be involved with psychosis?

  Glutamate, 5HT2, 5HT1A
• What is the critical potential role in schizophrenia?

  Environmental factors during brain development
• What is the aim of treatment for positive symptoms in schizophrenia?

  Decrease dopamine transmission in the mesolimbic pathway
• What do traditional antipsychotics primarily antagonize?

  D2 receptors in the mesolimbic system
• What do newer antipsychotic drugs target?

  Dopamine-serotonin antagonists or partial agonists
• What conditions do antipsychotics treat?

  Schizophrenia, mania, depression with hallucinations