Questions and Answers
Which drug is primarily used as an anti-craving agent in alcohol addiction?
What is an example of a defense mechanism where a person projects their feelings onto others?
Which of the following describes the defense mechanism of acting out?
In the context of Attention Deficit Hyperactivity Disorder (ADHD), what does the acronym HIA stand for?
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Which drug is used as an aversive therapy in the treatment of alcohol addiction?
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What type of defense mechanism involves making excuses for one’s mistakes?
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What is the result of regression as a defense mechanism?
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Which drug is primarily used to help individuals quit nicotine?
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What happens during the defense mechanism of displacement?
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What is the fundamental role of introjection as a defense mechanism?
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Study Notes
Antipsychotic Medications
- Typical antipsychotics primarily block D2 receptors; atypical antipsychotics block D2, 5HT2A, and 5HT2C receptors.
- Typical antipsychotics relieve only positive symptoms of schizophrenia; atypicals improve both positive and negative symptoms.
- Atypical antipsychotics have increased metabolic complications compared to typicals due to 5HT2C receptor involvement.
- Extrapyramidal reactions and hyperprolactinemia are more common with typical antipsychotics than atypicals.
Extrapyramidal Side Effects
- Acute Muscular Dystonia: Symptoms include abnormal posture, treated with promethazine or diphenhydramine.
- Parkinson's Disease Symptoms: Include resting tremors, rigidity, and bradykinesia; managed with centrally acting anticholinergics like benzhexol and biperidine.
- Akathisia: Characterized by restlessness; managed with propranolol, most common in smokers.
- Tardive Dyskinesia: Develops after months to years; permanent symptoms treated with valbenazine or tetrabenazine.
- Neuroleptic Malignant Syndrome: A potentially lethal complication presenting with hyperthermia, severe rigidity; treated with dantrolene.
Newer Antipsychotics
- Include cariprazine, brexpiprazole, lurasidone, iloperidone, luamteperone, and blonanserin.
Depression and Major Depressive Disorder
- Key neurotransmitters affected are serotonin, norepinephrine, and dopamine.
- Diagnosis requires symptoms lasting a minimum of 2 weeks, following SIGECAPS criteria.
- Dysthymia is chronic depression lasting over two years.
- Atypical depression presents with increased sleep and appetite, contrasting usual symptoms.
Types of Depression
- Postpartum Blues: Occurs immediately after birth, self-limiting with mood lability, lasts under 2 weeks.
- Postpartum Depression: Develops within a few months post-birth with low mood and guilt, treated with antidepressants.
- Postpartum Psychosis: High recurrence risk, manifests with severe symptoms including thoughts of harm to the newborn; treated with antipsychotics and antidepressants.
Cognitive Triad in Depression
- Involves negative views about self, environment, and future.
Treatments for Depression
- Antidepressants (SSRIs, SNRIs, NDRIs, TCAs) along with cognitive behavioral therapy (CBT) and electroconvulsive therapy (ECT) for severe cases.
- SSRIs commonly cause upper GI dysfunction and long-term sexual dysfunction.
- TCAs have anticholinergic side effects and are toxic in overdose; treated with sodium bicarbonate.
- Bupropion is an NDRI used for smoking cessation with a risk of seizures.
Mania
- Diagnosis requires a minimum of 7 days of elevated mood combined with DIGFAST criteria for symptoms.
Phobias
- Classified into agoraphobia, social phobia, and specific phobia, treated with systematic desensitization techniques.
Obsessive-Compulsive Disorder (OCD)
- First-line treatment includes SSRIs; clomipramine is most effective. Therapy of choice is exposure and response prevention (ERP).
Trauma and Stress-Related Disorders
- PTSD and acute stress disorder exhibit hyperarousal, intrusiveness, and avoidance after trauma, with CBT as the preferred therapy.
- Adjustment disorder arises after mild stress with symptoms developing within 1-3 months, treated with supportive psychotherapy.
Child Psychiatry
- Attention Deficit Hyperactivity Disorder (ADHD) characterized by hyperactivity, impulsivity, and attention deficits.
Ego Defense Mechanisms
- Denial, projection, regression, acting out, introjection, rationalization, repression, and displacement are common psychological defense mechanisms.
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Description
This quiz focuses on the metabolic side effects associated with atypical and typical antipsychotics, highlighting the differences between pines and dones. Learn about the primary actions of these medications and their relevance in psychiatric treatment. Test your knowledge on this essential topic in psychiatry.
