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Questions and Answers
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 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?
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What neurotransmitter is a precursor to norepinephrine?
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What was a major finding related to chlorpromazine (Thorazine)?
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What did studies with reserpine/Serpalan indicate about neurotransmitter depletion?
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What is a common side effect associated with antipsychotics?
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What is akathisia primarily characterized by?
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Which of the following is a common treatment for akathisia?
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What is tardive dyskinesia often associated with?
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What differentiates akathisia from anxiety symptoms?
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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?
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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.
