Antipsychotic drugscunicz抗精神病药物.pptVIP

Antipsychotic drugs Schizophrenia - symptoms Positive/active symptoms include thought disturbances, delusions, hallucinations Negative/passive symptoms include social withdrawal, loss of drive, diminished affect, paucity of speech. impaired personal hygiene DSM-IV Diagnosis Schizophrenia Symptoms 6 months Schizophreniform disorder Symptoms 1 month - 6 months Brief psychotic disorder Symptoms 1 day - 1 month Prevalence of Schizophrenia 1-2% of U.S. population 2 million diagnosed in U.S. Median age at diagnosis = mid-20’s Men = Women prevalence Men earlier diagnosis Worse premorbid history Worse prognosis Prognosis of Schizophrenia 10% continuous hospitalization 30% recovery = symptom-free for 5 years 60% continued problems in living/episodic periods Etiology Hereditary Influences may account for 10% of schizophrenia cases Prenatal Biological Trauma 5-10% cases of schizophrenia Perinatal biological trauma Diathesis - Stress Model Biological Treatment Insulin coma therapy, Prefrontal lobotomy, Electroconvulsive therapy Dr. Egas Moniz –Developed prefrontal lobotomy technique 1935 – heard about work on a chimp “Becky” –Performed surgery on many patients they were just calmer, but also more sluggish and apathetic Awarded the Nobel Prize in Physiology and Medicine Next 15 years - 50,000 lobotomies Schizophrenia Pathophysiology Schizophrenia - Dopamine Hypothesis Repeated administration of stimulants like amphetamines and cocaine, which enhance central dopaminergic neurotransmission, can cause a psychosis that resembles the positive symptoms of schizophrenia Low doses of amphetamine can induce a psychotic reaction in schizophrenics in remission Stress, a major predisposing factor in schizophrenia, can produce a psychotic state in recovered amphetamine addicts. Carlsson and Lindqvist (1963) first proposed that drugs such as chlorpromazine and haloperidol alleviate schizophrenic symptoms by blocking DA receptors and thereby reduce DA function. Thess antipsychoti