Pharmacotherapy of schizo

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Pharmacotherapy of schizo

Hyperprolactinemia

Sxs/Management

Tardive Dyskinesia - chronic/possibly irreversible

Treatment

EPS: Acute Presentations

Pseudoparkinsonism Manifestations

Schizo treatment

-meds +/- psychotherapy -antipsychotics --> GREAT for + -less role in - -psychotherapy does NOT have much of a role by itself/used adj

Second Gen

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

First Gen

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

Psychosis

Disorders associ. w/ psychosis

-Schizoaffective -Mood disorders -dementia -personality disorders -medical conditions

Schizophrenia

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.

-loss of reality, inability to distinguish what is real/not -described in terms relating to thoughts/sensations that occur when they shouldn't

-dopaminergic response -symptoms incl. hallucinations, delusions, paranoia