PSYCH 265 1st Edition Lecture 28Outline of Last Lecture I. MAO-I abuse II. SSRI abuseIII. Psychosis IV. SchizophreniaV. Public perception of schizophrenia VI. DID is not the same as schizophrenia Outline of Current Lecture I. Brain areas affects in schizo & parkinson’s II. EPSIII. Extrapyramidal motor controlIV. Signs of EPSV. Etiology of TDVI. Treatments of drug abuse VII. Abuse potential of neuroleptics VIII. Genetics of schizophrenia Current Lecture-Brain areas affected in schizo & Parkinson's disease oSchizo involves overactivation of DA receptors in mesolimbic & mesocortical pathways oParkinson's involves under activation of DA in nigrostriatal pathwayThese notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.-Extrapyramidal Syndrome (EPS)oParkinson's due to underactivatio not DA receptors due to degeneration of nigrostriatatal pathway oEPS is due to under activation of striatal DA receptors due to neuroleptic blockade of receptors -Extrapyramidal Motor Control oDelicate balance between DA and Ach in regulation of the extrapyramidal motor system oParkinson's results from deficiency of DAoHuntington's disease results from overabundance of DA-Signs of EPSoDystoniaMuscle spasms & contractions oAkathisia Motor restlessnessoParkinsonism Rigidity, bradykinesia, tremoroTardive dyskinesia Buccolinguomasticatory movements -Tardive dyskinesia oTD one of most troubling side effects of neuroleptic drugs that can arise after months or years of treatment oPrimarily associated with classical neuroleptics but have been reported for some atypicalneuroleptics oCharacterized by random movements of different muscles usually in lower faceFacial grimacing Jaw swinging Tongue thrusting Repetitive chewing oNot life-threatening but can be embarrassing and possibly debilitating depending on severity -Etiology of TDoEarly TD, striatal DA receptors are temp sensitized and overrespond to DASigns of TD can be reversed by reducing neuroleptic doseoLate TD, striatal DA receptors are permanently sensitized Signs of TD can be reversed by increasing the neuroleptic dose-Treatment of drug abuse oChlorpromazine was long considered the universal antidote for drug-induced psychotic behavior oHas ability to competitively block multiple neurotransmitter receptors DA receptors Alpha-adrenergic receptors Muscarinic cholinergic receptors Histamine receptors Many serotonin receptor subtypes-Abuse potential of neuroleptics oTypically not considered drugs of abuse oAtypical antipsychotics now used to enhance effects of other drugs or counter effect the adverse effects of illicit drugs oNY studyAtypical antipsychotics reported to be most commonly used w/ alcohol, opioids, cocaine, or in combo oOf 429 patients from detox & rehab units of addiction institute of NY who were screened, 17% reported illegal or non-medical use of prescribed atypical antipsychotics-Genetics of
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