Study Guide abnormal Exam 3 review

O dopamine hypothesis excess dopamine activity o

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Know in general what the dopamine hypothesis is, and the evidence for and against it. o Dopamine Hypothesis (excess dopamine activity): o Evidence in Support Antipsychotic meds block dopamine activity, reduce positive
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symptoms Side effects of antipsychotic meds resemble Parkinson’s Disease, caused by low dopamine L-dopa (med for Parkinson’s) produces psychotic symptoms in some Parkinson’s patients Amphetamines increase dopamine activity: may produce amphetamine psychosis; may exacerbate psychosis in schizophrenia patients - Dopamine Hypothesis: contrary evidence o Many with schizophrenia not helped by dopamine antagonists (antipsychotics) o Dopamine blocking occurs quickly, but symptoms go away over days/weeks o Antipsychotics have little impact on negative symptoms. o Olanzapine is effective as antipsychotic, but is a weak dopamine antagonist. o Conclusion: Dopamine levels in different brain areas may be over- active or under-active o Dopamine has complex interactions with glutamate, which may also play a role in symptoms. Know what “expressed emotion” refers to and how it is related to relapse. - High expressed emotion (high EE) o Characterized by hostility, unnecessary criticism, or emotional over- involvement - High EE predicts relapse o If the patient is released to a high EE family, they have a higher chance of relapsing. Know about the role of antipsychotics, as well as psychotherapy/family therapy, in treating schizophrenia. Traditional antipsychotics Dopamine antagonists - block the action of dopamine Reduce positive symptoms in 75-80% of patients Can reduce the risk of relapse Side effects: Tardive dyskinesia Permanent side effect of traditional antipsychotic medications Involuntary lip smacking and odd facial contortions Other movement-related symptoms Sedation, tremors, weight gain, sense of physical restlessness Atypical (2 nd generation) antipsychotics Affect dopamine and serotonin activity but create fewer movement-related side effects than traditional antipsychotics Reduce both positive and negative symptoms with long-term use No tardive dyskinesia Can reduce comorbid anxiety and depression Side effects of weight gain, risk of heart problems, diabetes Treatments address three of the four general treatment steps: Identify early warning signs of positive and negative symptoms through
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family education and therapy Hospitalization when necessary to prevent harm to oneself or others, or when unable to take care of himself or herself Reduce certain negative symptoms through social skills training and improve overall functioning and quality of life through community-based interventions
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