Podcast
Questions and Answers
Which statement about tardive dyskinesia is accurate?
Which statement about tardive dyskinesia is accurate?
What was the percentage of individuals with schizophrenia who died in the 17-year follow-up study?
What was the percentage of individuals with schizophrenia who died in the 17-year follow-up study?
What does the research suggest about the genetic basis of schizophrenia in relation to Bipolar I disorder?
What does the research suggest about the genetic basis of schizophrenia in relation to Bipolar I disorder?
According to the findings, what happens to the risk for premature death as the number of neuroleptics taken increases?
According to the findings, what happens to the risk for premature death as the number of neuroleptics taken increases?
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What neurotransmitter is a precursor to norepinephrine?
What neurotransmitter is a precursor to norepinephrine?
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What was a major finding related to chlorpromazine (Thorazine)?
What was a major finding related to chlorpromazine (Thorazine)?
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What did studies with reserpine/Serpalan indicate about neurotransmitter depletion?
What did studies with reserpine/Serpalan indicate about neurotransmitter depletion?
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What is a common side effect associated with antipsychotics?
What is a common side effect associated with antipsychotics?
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What is akathisia primarily characterized by?
What is akathisia primarily characterized by?
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Which of the following is a common treatment for akathisia?
Which of the following is a common treatment for akathisia?
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What is tardive dyskinesia often associated with?
What is tardive dyskinesia often associated with?
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What differentiates akathisia from anxiety symptoms?
What differentiates akathisia from anxiety symptoms?
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What percentage of clients may experience Parkinsonism as a side effect of neuroleptic medications?
What percentage of clients may experience Parkinsonism as a side effect of neuroleptic medications?
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Which of the following factors plays a role in the development of Parkinsonism in clients on neuroleptics?
Which of the following factors plays a role in the development of Parkinsonism in clients on neuroleptics?
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What type of agents are typically used to treat Parkinsonism caused by neuroleptics?
What type of agents are typically used to treat Parkinsonism caused by neuroleptics?
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Study Notes
Schizophrenia
- Schizophrenia involves genetic factors, and the precise genes and gene-environment interactions are yet to be clarified
- Schizophrenia shares many heritable factors with Bipolar I disorder, suggesting there may be an underlying genetic basis for both disorders that runs on a continuum
- The phenotypic complexity of Schizophrenia, together with the multifarious nature of the ‘group’ of ‘schizophrenic psychoses’ limits our ability to form a simple and logical biologically based hypothesis of the disease group
Treating Schizophrenia
- There are agents that can be used to treat the symptoms of Schizophrenia, but they do not really differ much from one another in general effectiveness
- The mechanisms underlying Schizophrenia and it's progression need to be understood, in order to move beyond symptom management
- Although they were widely used, chlorpromazine/Thorazine and other neuroleptics were used before their mechanisms of action were isolated
Side Effects of Neuroleptics
- Neuroleptics can cause extrapyramidal side effects (EPSs) that occur early in the course of therapy
- Early-onset side effects include akathisia and parkinsonism
- Late-onset side effects include tardive dyskinesia and neuroleptic malignant syndrome (NMS)
Akathisia
- Akathisia is a feeling of restlessness and an inability to sit still
- Akathisia may cause the client to pace, fidget, or even rock back and forth in the chair
- Akathisia can be treated with benzodiazepines, anti-Parkinsonian agents, and beta-blockers
Parkinsonism
- Parkinsonism is a side effect characterized by muscular rigidity, slowed movement, tremors, and bradykinesia
- Parkinsonism is treated with anticholinergic agents, such as benztropine
- Once the neuroleptic is discontinued, the symptoms of Parkinsonism often vanish within weeks to months
Tardive Dyskinesia
- Tardive dyskinesia is a late-appearing abnormal movement of the mouth, lips, and tongue
- It may be accompanied by involuntary twitching and jerking of muscles (choreic movement)
- Tardive dyskinesia is a serious side effect that can be irreversible
- Tardive dyskinesia affects on average 15 to 20% of clients on neuroleptics
- The incidence of tardive dyskinesia is higher in older adults
- People with schizophrenia have a 31 times higher chance of developing tardive dyskinesia than those in the general population
Neuroleptic Malignant Syndrome (NMS)
- NMS is a life-threatening condition that can occur with the use of neuroleptics
- NMS is characterized by fever, muscle rigidity, altered mental status, and autonomic instability
- NMS is a rare condition and fatalities are rare due to the decrease in neuroleptic use and early detection
- If the medication is discontinued in time, most cases resolve within a month
- NMS is uncommon, and most patients recover without long term effects
Agents to Treat Extrapyramidal Side Effects
- Anti-Parkinsonian agents are used to treat early-onset extrapyramidal symptoms
- These side effects result from neuroleptic-induced blockade of dopamine receptors in the nigrostriatal pathway
- Experimental studies have been conducted to examine calcium channel blockers as potential treatments for EPSs
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Description
Explore the complexities of schizophrenia, including its genetic factors and the challenges in forming a biological hypothesis. Learn about treatment options and their effectiveness, as well as the need for a deeper understanding of the disease mechanisms. This quiz covers essential concepts related to schizophrenia and its management.
