by Qabas Al-Jobori 10 months ago
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Clozapine: 1st atypical
ADEs -REMS Program for Agranulocytosis/Neutropenia -Weight gain, hyperlipidemia, hyperglycemia -seizures -anticholinergic effects
-low D2/high 5HT2 blockade -LAST LINE, beneficial in pts w/ EPS, suicidality/treatment resistant schizo.
-atypical -D2 + serotonin (5HT2A) RA -less specific to dopamine -effective for (+) sxs
Monitoring: -movement (AIMS or other scale) -prolactin lvls -cognition (MMSE) -QTc -Vitals (BP, HR, weight) -EEG/Seizure
ADEs
Drugs
Effects
-typical -D2 RA -block H1/M1/a1 -more specific to dopamine -effective for (+) sxs
Clinical presentation:
Negative: -lack of interest/withdrawal from the world -emotionless/flat affect The A's: -Avolition, Alogia, Anhedonia, Asociality
Positive: -hallucinations -auditory/visual/tactile -delusions
Psychosis vs. Schizo
schizo: -mental illness that impacts thought process/emotion/behavior -diagnosis: must experience at least 2 of the following sxs for 6 months, incl one of the first 3 Sxs: -Delusions -hallucinations -disorganized speech -catatonic behavior -negative symptoms (lessened emotional expression)
Psychosis: -episode where one is detached from reality -symptom of sleep deprivation, substance use, mental illness, etc. -signs: hallucinations, delusions, agitation, disorganized thought/behavior
DSM5: two or more of these present for at least 1 mo
1. hallucinations 2. delusions 3. disorganized speech 4. grossly disorganized or catatonic behavior 5. negative sxs + cont. disturbance for 6mo, social/occupational dysfun for sig time.