Difficulty or distortion in voluntary movement

Dyskinesia

A disorder characterized by involuntary movements, especially involving the face, mouth, lips, and tongue. Can be caused by prolonged use of antipsychotic drugs, like chloropromazine

Tardive Dyskinesia

An exaggerated psychosis that emerges when there is a decrease in antipsychotic medication dosage that can be due to a consequence of up regulation of receptors that occured during drug treatment.

Supersensitivity Psychosis

While the discovery of antipsychotic drugs helped with the treatment of schizophrenia, there were quite significant side effects.

- Dyskinesia
- Tardive Dyskinesia
- Supersensitivity psychosis
- Involuntary movements of the arms, legs, tongue and facial muscles, resulting in Parkinson’s-like tremors

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A class of drugs that typically alleviate symptoms of schizophrenia. (Also called neuroleptics)

- The Dopamine Hypothesis

- Typical Antipsychotics

- Long-Term Effects of Antipsychotic Drugs

- Atypical Antipsychotics

- The Glutamate Hypothesis

Antipsychotic Drugs

Antipsychotics are a drug class used to treat psychosis and other related disorders, such as schizophrenia. There are two types of antipsychotics: first-generation or typical antipsychotics include drugs like haloperidol, and second-generation or atypical antipsychotics include drugs like risperidone. Common brand names include Haldol, Mellaril, Prolixin, and Thorazine.

Antipsychotics

Breedlove, S. & Watson, N. (2017). Behavioral neuroscience, eighth edition. Oxford University Press.

Behavioral Neuroscience 8th Edition

Spielman, R. M., Jenkins, W. J., & Lovett, M. D. (2020, April 22). Psychology (2nd ed.). OpenStax. https://openstax.org/books/psychology-2e/pages/1-introduction

OpenStax Psychology (2nd ed.) Textbook

Hypothesis: Schizophrenia results from an underactivation of glutamate receptors.

- Origin of Hypothesis

The Glutamate Hypothesis of Antipsychotics

Long-Term Effects of Antipsychotic Drugs

These are a class of antipsychotic drugs that have a high affinity for other types of receptors and not dopamine receptors. They are also known as 2nd Generation Antipsychotics. They can be prescribed for Schizophrenia and other types of severe thought disorders. They can target dopamine and serotonin receptors to treat schizophrenia's negative symptoms, such as withdrawal and apathy; newer drugs may treat both positive and negative symptoms.

Atypical Antipsychotics include: 
- Aripiprazole (Abilify)

- Clozapine (Clozaril)

- Olanzapine (Zyprexa)

- Quetiapine (Seroquel)

- Risperidone (Risperdal)

- Ziprasidone (Geodon)

Atypical Antipsychotics

Typical Antipsychotic are separated into 1st Generation and 2nd Generation.

1st Generation Antipsychotics include:  
- Chlorpromazine

- Mesoridazine 

- Perphenazine 

- Thioridazine 

- Trifluoperazine 

- Butyrophenone 

- Haloperidol 

- Others:  Loxapine, Molindone, Thiothixene 


Typical Antipsychotics

Both typical and atypical antipsychotics appear to inhibit the release of pro-inflammatory cytokines and potentially promote regular neurogenesis in schizophrenia patients by decreasing oxidative stress. Studies of prenatal administration of some antipsychotics in mice models have demonstrated a decrease in psychosis-like behaviors in the offspring. Given that the microglial inflammatory mechanisms are particularly pronounced in schizophrenia, this is a particular area of interest for future pharmacological research.

Effects of Antipsychotics on Microglia

The dopamine hypothesis posits that schizophrenia is linked to irregularities in the dopamine system. The original theory suggested that the disorder was caused by a general excess of dopamine or an overabundance of dopamine receptors. However, this view has been refined. More recent research indicates that dopamine abnormalities are specific to different brain regions. An oversupply of dopamine in the limbic system is thought to be responsible for positive symptoms like hallucinations and delusions, while a deficit of dopamine in the prefrontal cortex is associated with negative symptoms such as avolition and alogia.

The Dopamine Hypothesis of Schizophrenia

A major class of antischizophrenic drugs that share an antagonist activity at dopamine D2 receptors

Antipsychotics work by inhibiting the neurotransmitter dopamine to treat positive psychotic symptoms such as auditory and visual hallucinations, delusions, and paranoia.  

Antipsychotics Mechanism of Action 

Based on the patient's symptoms described in the case study, which class of psychotropic medication would a psychiatrist most likely consider as a primary treatment? Explain your reasoning.

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