CHEM 2201 Lecture Notes - Lecture 2: Cerebral Atrophy, Auditory Hallucination, Thought Insertion

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14 May 2016
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Derailment (change subject completely mid-conversation: delusions. Can be quite elaborate and resistant to change. Sensory perceptions in the absence of external stimuli. Poor response to neuroleptic: atypical neurolyptics risperdal (risperidone) and clozaril (clozapine) Includes: avolition/apathy (loss of interest/motivation, alogia (poverty of speech, anhedonia (loss of interest/pleasure, flat affect (unchanging expressions) Catatonia: grimaces, odd facial expressions, repeated eccentric gestures, catatonic immobility/stupor, waxy flexibility/posturing, negativity/rigidity. Inappropriate affect: causeless laughter, hebephrenia, spontaneous tearfulness. Lack of insight: do not know they have a problem or refuse to acknowledge it, especially good specificity (>95% of schizophrenics) Twin studies: mz-dz 46% vs 14, negative symptoms have highest concordance. Multiple studies found genetic loci but showed low replicability. Biochemical factors: schizophrenia is associated with excessive functional dopamine, parkinson"s disease is associated with low functional dopamine, neuroleptics that affect d2 receptors have a more stable effect of controlling schizophrenia. Effects mainly on positive symptoms: atypical drugs treatment. Dry mouth, blurred vision, grogginess, low blood pressure.