Schizophrenia

• Schizophrenia is a serious mental illness that affects how a person thinks, feels, and behaves.
• People with schizophrenia may seem like they have lost touch with reality, which can be distressing for them and for their family and friends.
• Schizophrenia usually involves delusions (false beliefs), hallucinations (seeing or hearing things that don’t exist), unusual physical behavior, and disorganized thinking and speech.
• It is common for people with schizophrenia to have paranoid thoughts or hear voices.
• When does schizophrenia typically develop?

  ● The symptoms of schizophrenia usually emerge when a person is in their late teens or early 30s. They tend to develop earlier in males than in females.

  ● Sometimes, a person will start to show unusual behaviors from childhood, but these only become significant as they get older. In others, the symptoms may appear suddenly.
• Types

  Paranoid type

  ● Before 2013, healthcare professionals considered paranoid schizophrenia a distinct type of schizophrenia.

  ● However, the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR), which provides expert guidelines, dropped that classification in 2016.

  ● It now classifies paranoia as a symptom, rather than a subtype, of the disorder.
• What’s it like to have a paranoid type?

  ● Paranoid delusions, also called delusions of persecution, reflect profound fear and anxiety along with the loss of the ability to tell what's real and what's not real.

  ● They might make you feel like A co-worker is trying to hurt you, like poisoning your food. Your spouse or partner is cheating on you.
• Disorganized type

  ● Disorganized schizophrenia is also called hebephrenic schizophrenia because it usually develops during the teen years.

  ● Disorganized schizophrenia is associated with symptoms like disorganized speech, thinking, and behavior. These can make it difficult to carry out daily tasks and communicate with others.

  ● The condition is also known as hebephrenia, named after the Greek term for "adolescence" – ἥβη (hḗbē) – and possibly the ancient-Greek goddess of youth, Hebe, daughter of Hera.
• Catatonic type

  ● Catatonic schizophrenia affects the way you move in extreme ways. You might stay totally still and mute. Or you might get hyperactive for no reason.

  ● The new name for this condition is schizophrenia with catatonic features or schizophrenia with catatonia.

  ● Catatonia refers to a set of symptoms that might develop in some patients with schizophrenia.

  ● It can include periods where the individual moves very little and does not respond to instructions.

  
• Symptoms and causes

  
• What does ‘paranoia’ mean, and what does it look like?

  ● feeling upset, anxious, angry, and confused

  ● being suspicious of those around them

  ● believing that someone is persecuting them

  ● fearing that someone is following, chasing,

  poisoning, or otherwise plotting against them

  ● feeling as if someone else is controlling their

  thoughts and actions

  ● feeling as if their thoughts are disappearing or

  being taken away from them

  Symptoms of catatonic schizophrenia

  
• 3 phenomenons involved in catatonia

  
• The difference between paranoid and catatonic schizophrenia

  ● The term “paranoid schizophrenia” is also obsolete in the sense that it no longer applies to a diagnosis. Experts considered paranoia, delusions, and hallucinations to be the key characteristics of paranoid schizophrenia.

  ● The term catatonic schizophrenia refers to schizophrenia in which catatonia is the most prominent feature.
• Symptoms of disorganized type

  ● Problems with routine tasks like dressing, bathing, and brushing teeth.

  ● Showing emotions that are not appropriate to the situation.

  ● Blunted or flat affect.

  ● Impaired communication ability, including speech.

  ● Problems with the use and ordering of words.
• Main causes of disorganized type

  ● A family history of schizophrenia.

  ● A viral infection as a fetus during pregnancy (e.g.,

  influenza, herpes, toxoplasmosis, rubella)

  ● Malnutrition as a fetus during pregnancy.

  ● Experiencing severe stress during early life.

  ● Being born to older parents.
• Risk factors

  ● Having a family history of schizophrenia.

  ● Some pregnancy and birth complications,

  such as malnutrition or exposure to toxins

  or viruses may impact brain development.

  ● Taking mind-altering (psychoactive or

  psychotropic) drugs during teen years and young adulthood.

  
• Diagnostic criteria

  DSM-V CRITERIA

  ● HALLUCINATIO NS

  ● DELUSIONS

  ● DISORGANIZED SPEECH

  
• Management

  ● Medications are the cornerstone of schizophrenia treatment, and antipsychotic medications are the most prescribed drugs.

  ● They're thought to control symptoms by affecting the brain neurotransmitter dopamine.
• First-Gen Antipsychotics

  ● First-generation antipsychotics (FGAs), also known as “typical antipsychotics,” were developed in the 1950s.

  ● FGAs were first developed for the treatment of psychosis (e.g., schizophrenia). Since then, they have also been proven effective in the treatment of other conditions including acute mania, agitation, and bipolar disorder.

  ● Most FGAs are phenothiazine derivatives and are confounded by their varying degrees of dopamine (e.g., D1–D5), histamine, and cholinergic receptor antagonism.

  FGA

  ● Chlorpromazine

  ● Fluphenazine

  ● Haloperidol

  ● Perphenazine
• First-generation antipsychotics are better for treating positive symptoms of schizophrenia, e.g., hallucinations, and delusions, among others.

  They also decrease the risk of a repeat episode of psychosis.

  These antipsychotics are often cheaper than second-generation antipsychotics, especially the generic versions, which can be an important consideration when long-term treatment is necessary.

  
• Perphenazine MOA

  ● Perphenazine is used to treat the symptoms of schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions).

  ● Perphenazine is also used to control severe nausea and vomiting in adults.

  
• Second-gen Antipsychotics

  ● Second-generation antipsychotics are serotonin-dopamine antagonists and are also known as atypical antipsychotics.

  ● The Food and Drug Administration (FDA) has approved 12 atypical antipsychotics as of the year 2016.

  Second-gen Antipsychotics

  ● Second-generation antipsychotics are serotonin-dopamine antagonists and are also known as atypical antipsychotics.

  ● The Food and Drug Administration (FDA) has approved 12 atypical antipsychotics as of the year 2016.

  SGA

  • ARIPIPRAZOLE
  • CLOZAPINE
  • OLANZAPINE
  • QUETIAPINE
  • PALIPERIDONE RISPERIDONE
• ABILIFY

  ● Aripiprazole is used to treat certain mental/mood disorders (such as bipolar disorder, schizophrenia, Tourette's syndrome, and irritability associated with autistic disorder).

  ● It may also be used in combination with other medication to treat depression. Aripiprazole is known as an antipsychotic drug (atypical type).

  ● It works by helping to restore the balance of certain natural chemicals in the brain (neurotransmitters).

  
• CLOZAPINE

  ● Clozapine is part of a group of drugs known as second-generation antipsychotics or atypical antipsychotics.

  ● Antipsychotic drugs are vital in treating the core symptoms of schizophrenia: hallucinations and delusions.

  ● Clozapine is used to treat severely ill patients with schizophrenia who have used other medicines that did not work well. It is also used to lower the risk of suicidal behavior in patients with schizophrenia or schizoaffective disorder.

  
• Quetiapine

  ● Quetiapine is known as an anti-psychotic drug (atypical type). It works by helping to restore the balance of certain natural substances (neurotransmitters) in the brain.

  ● This medication can decrease hallucinations and improve your concentration.

  
• RISPERIDONE

  ● Risperidone is an atypical antipsychotic medication, first approved for use in the USA by the Food and Drug Administration (FDA) in 1993.

  ● The FDA-approved indications for oral risperidone (tablets, oral solution, and M-TABs) include the treatment of Schizophrenia (in adults and children aged 13 and up)

  
• Expected Effects from a Drug's Blockade of Receptors