What are rain Psychotropic Drugs?
Psychotropic drugs: chemical substances that change brain function and result in alterations in perception, mood, consciousness or behavior
What are Psychotherapeutic agents?
Psychotherapeutic agents: licensed psychotropic drug exerting therapeutic benefit
What are Psychomimetics?
Psychomimetics: affects psyche without therapeutic value (drugs of abuse: e.g. MDMA, Mescalin)
How do Psychotherapeutic agents tackle mental disorders? What Psychotherapeutic agents are used for what emotion?
What is the Prevalence of Depression in men and women?
What are the reasons fo developping a depression?
What are the criteria of depression? How do you diagnose it?
What is the Monoamine hypothesis of depression?
In the 1950s, the prescribed treatment for high blood pressure was a drug called reserpine; a terrible side effect was soon apparent: the admittedly now calm patients had become severely depressed, bordering on suicidal
1951 accidental discovery of the mood elevatory effect of iproniazide (tubercolosis)
1952 Identification of MOA (Inhibition of Monoaminoxidase (MAO))
non-selective (Tranylcypromine)
selective MAO-A-Inhibitor (Moclobemide)
MAO-Inhibitors reverse depressive effects of reserpin
—> Monoamine hypothesis of depression
What are the three possible effects after antidepressant intake?
What are the Pros of Monoamine-Hypothesis?
What are the Cons of Monoamine-Hypothesis?
What happens in a depression molecularly?
monoamine deficiency causes upregulation of postsynaptic monoamine neurotransmitter receptors, and this leads to an increased sensitivity for NA, DA and 5-HT receptors
What mechanisms achieve an increase of MAO? How can the mechanisms be inhibited?
What are the three main effects of antidepressants?
antidepressive (mood elevating)
psychomotoric activation (motivation),
depression (sedation) anxiolysis
What are the anticholinergic effects of TCA?
What are the cardiovascular disorders caused by TCA?
What are the antihistaminergic effects of TCA?
What are SSRIs?
Name four advantages of SSRI over TCA:
less sedation
less anticholinergic effects
less arrythmias
lower risk of intoxication
What is the effect of mirtazapine on aminergic neurons?
alpha2-antagonists profile
brain St. john's wort plant profile
Overview
antidepressive drugs and side-effects
receptors
What are the disorders of schizophrenia?
disorders of thinking, perception and affect, the relationship to the environment
Schizophrenia Prognosis
10 - 30% remission
60% recurrences
30% stationary treatment
10 – 15% commit suicide
What is the ethiology of schizophrenia?
genetic/organic
50% concordance in identical twins • dopamine-hypothesis
other neurotransmitters
morphologic / functional correlates
environment
„Vulnerability-Stress-Coping-Model“ (how sensitive are you to developing schizophrenia)
neurotransmitters and brain circuits in schizophrenia
What is the dopamine hypthesis of schizophrenoa?
assumption: schizophrenia is due to an enhancement of dopaminergic activity (specifically in mesolimbic areas)
What are the effects of antipsychotics?
standard AP are D2-blocker (what about reserpine!?)
binding affinity is proportional to effectiveness
clozapine antagonises also D4 and 5HT2 receptors
risperidone antagonises D2 and 5HT2 receptors
he mood brain dopamine pathways in schizophrenia
What are the pros and cons of the dopamine hypothesis?
PRO (don’t learn words):
amphetamine effects in humans —> induction of psychotic symptoms
bromocriptine/apomorphine effects in animal behaviour —> stereotypic behaviour
correlation between potency of antipsychotics & D2-receptor affinity
CON:
lack of evidence for elevated dopamine metabolites
latency of antipsychotics-induced effects
possible explanation:
initially, elevated DA release
D2 receptors↓ and DA release↓ during ongoing treatment
What are dopamin hypothesis alternatives?
overview of most important side effects (dopamine hypothesis?)
extrapyramidal symptoms
hyperprolactinemia sedation
weight gain
anticholinergic / adrenergic vegetative side effects
epileptic seizures
What are Endocrine effects?
galaktorrhoea= milk production without pregnancy
gynecomastia = breast production
What is meant by antipsychotic effects ?
antipsychotics: classification into
Name two conventional antipsychotics.
chlorpromazine, haloperidol
What makes an antipsychotic “atypical”?
pharmacologically:
Dopamine receptor (D2) antagonist
Serotonin (5HT2A) antagonist
binding affinity: D2 < 5HT2A
D2 / 5HT1A partial agonist
clinically
improved effectivness against negativ symptoms
reduced occurence of dyskinesia
clozapine: receptor profile
antipsychotics: summary
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