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the neuropharmacology slide note according to the neuroleptic drugs

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  1. 1. Neuroleptic/ antipsychotics
  2. 2. Definition <ul><li>Neurosis </li></ul><ul><ul><li>Abnormal behavior characterized by increased anxiety, tension and emotionalism </li></ul></ul><ul><li>Psychosis </li></ul><ul><ul><li>Severe psychiatric illness with distortion of thought and behaviors, capacity to recognized reality and of perception Depression </li></ul></ul><ul><li>Depressant </li></ul><ul><ul><li>Mental state characterized by depressed mood with feelings of frustration and hopelessness </li></ul></ul>
  3. 3. Psychotic disorders <ul><li>1.) Psychoses </li></ul><ul><li>(a) Schizophenia (split mind) </li></ul><ul><ul><li>splitting of perception and interpretation from reality </li></ul></ul><ul><ul><li>inability of thinking coherently </li></ul></ul><ul><li>(b) Mania </li></ul><ul><ul><li>Elation, hyperactivity, uncontrollable thought and speech </li></ul></ul><ul><ul><li>maybe associated with violet behaviour </li></ul></ul><ul><li>(c) Depression </li></ul><ul><ul><li>Sadness, guilt, physical and mental slowing </li></ul></ul><ul><ul><li>self-destructive ideation </li></ul></ul>2.) Neuroses (less seriousness) (a) Anxiety An unpleasant emotional state associated with uneasiness and concern for the future (b) Obsessive / Compulsive limited abnormality of talk or behaviour
  4. 4. Schizophrenia <ul><li>One of the psychotic disorders </li></ul><ul><li>Major disturbances in: </li></ul><ul><ul><li>Thought </li></ul></ul><ul><ul><li>Emotion </li></ul></ul><ul><ul><li>Behavior </li></ul></ul><ul><li>Disordered thinking </li></ul><ul><li>Faulty perception and attention </li></ul><ul><li>Inappropriate or flat emotions </li></ul><ul><li>Bizarre motor activity </li></ul><ul><li>Disrupted interpersonal relationships </li></ul>
  5. 5. Schizophrenia <ul><li>Disorder impacts families & friends </li></ul><ul><ul><li>Difficult to live with someone who experiences delusions, hallucinations, and paranoia. </li></ul></ul><ul><ul><li>Social skills deficits common </li></ul></ul><ul><ul><ul><li>Isolation, few social contacts </li></ul></ul></ul><ul><li>Symptoms impact employability </li></ul><ul><ul><li>Often lead to unemployment & homelessness </li></ul></ul><ul><li>Substance abuse & suicide rates high </li></ul>
  6. 6. Schizophrenia <ul><li>Lifetime prevalence ~1% </li></ul><ul><li>Occurs equally in men and women </li></ul><ul><li>Onset typically late adolescence or early adulthood </li></ul><ul><ul><li>Men diagnosed at a slightly earlier age </li></ul></ul><ul><li>Diagnosed more frequently in African Americans </li></ul><ul><ul><li>May reflect diagnostician bias </li></ul></ul>
  7. 7. Positive Symptoms: Behavioral excesses <ul><li>Delusions </li></ul><ul><ul><li>Firmly held beliefs </li></ul></ul><ul><ul><li>Contrary to reality </li></ul></ul><ul><ul><li>Resistant to disconfirming evidence </li></ul></ul><ul><li>Persecutory delusions common </li></ul><ul><ul><ul><li>“ The CIA has planted a listening device in my head” </li></ul></ul></ul><ul><li>Hallucinations </li></ul><ul><ul><li>Sensory experiences in the absence of sensory stimulation </li></ul></ul><ul><li>Types of hallucinations </li></ul><ul><ul><li>Audible thoughts </li></ul></ul><ul><ul><li>Voices commenting </li></ul></ul><ul><ul><li>Voices arguing </li></ul></ul><ul><li>Increased levels of activity in Broca’s area during hallucinations </li></ul>
  8. 8. Negative Symptoms: Behavioral deficits <ul><li>Avolition </li></ul><ul><ul><li>Lack of interest and drive </li></ul></ul><ul><li>Alogia </li></ul><ul><ul><li>Poverty of speech </li></ul></ul><ul><ul><li>Poverty of content </li></ul></ul><ul><li>Anhendonia </li></ul><ul><ul><li>Inability to experience pleasure </li></ul></ul><ul><li>Flat affect </li></ul><ul><ul><li>Exhibits little or no affect in face or voice </li></ul></ul><ul><li>Asociality </li></ul><ul><ul><li>Inability to form close personal relationships </li></ul></ul>
  9. 9. Other Symptoms <ul><li>Catatonia </li></ul><ul><ul><li>Motor abnormalities </li></ul></ul><ul><ul><li>Repetitive, complex gestures </li></ul></ul><ul><ul><ul><li>Usually of the fingers or hands </li></ul></ul></ul><ul><ul><li>Excitable, wild flailing of limbs </li></ul></ul><ul><li>Catatonic immobility </li></ul><ul><ul><li>Maintain unusual posture for long periods of time </li></ul></ul><ul><ul><ul><li>e.g., stand on one leg </li></ul></ul></ul><ul><li>Waxy flexibility </li></ul><ul><ul><li>Limbs can be manipulated and posed by another person </li></ul></ul><ul><li>Inappropriate affect </li></ul><ul><ul><li>Emotional responses inconsistent with situation </li></ul></ul><ul><ul><ul><li>e.g., laugh uncontrollably at a funeral </li></ul></ul></ul>
  10. 10. NEUROLEPTIC DRUGS <ul><li>Mechanism of Action </li></ul><ul><ul><li>Dopamine receptor blocking activity in the brain </li></ul></ul><ul><ul><li>Serotonin receptor blocking activity in the brain. </li></ul></ul>
  11. 11. Dopamine receptor blocking activity in the brain <ul><li>All neuroleptic drugs block dopamine receptors in th brain and the periphery. </li></ul><ul><li>Five types of dopamine receptors  D1,D2,D3,D4,D5. </li></ul><ul><li>D1 and D5  activate adenylyl cyclase </li></ul><ul><li>D2,D3,D4  inhibit adenylyl cyclase </li></ul><ul><li>Adenylyl cyclase  an enzyme that initiates the conversion of adenosine triphosphate (ATP) to cyclic adenosine monophosphate (cAMP). </li></ul>
  12. 13. Dopamine Theory of Schizophrenia
  13. 14. Serotonin receptor blocking activity in the brain. <ul><li>Newer agents atypical agents appear to exert part of their unique actions. </li></ul><ul><li>through inhibition of serotonin receptors (5-HT). </li></ul><ul><li>Example of drug clozapine(1/2) : Has high affinity for D1, D2, D4, D5, 5 HT2, muscarinic and alpha adrenergic receptors. </li></ul><ul><li>Example of drug Risperidone (1/2) : blocks 5-HT2 receptors more than D2 receptors. </li></ul>
  14. 15. Outcome <ul><li>Antipsychotic actions. </li></ul><ul><li>Reduces hallucinations and delusions associated with schizophrenia by blocking dopamine receptors in the mesolimbic system of the brain. </li></ul><ul><li>Causes parkinson like symptoms. </li></ul>
  15. 16. Drug suitable for treating Schizopherenia <ul><li>Has antipsychotic actions </li></ul><ul><li>Reduce hallucination </li></ul><ul><li>Reduce delusions </li></ul><ul><li>Suitable in treating negative symptoms of schizophrenia such as withdrawal, blunted emotions and reduced ability to relate to other people </li></ul>
  16. 17. Example of drugs <ul><li>Fluphenazine </li></ul><ul><li>Chlorpromazine </li></ul><ul><li>Prochlorperazine </li></ul><ul><li>Promethazone </li></ul><ul><li>Thiordazine </li></ul><ul><li>Fluphenazine </li></ul><ul><li>Haloperidol </li></ul><ul><li>Pomazide </li></ul><ul><li>Thiothxene </li></ul><ul><li>Aripiprazole </li></ul><ul><li>Clozapine </li></ul><ul><li>Olanzapine </li></ul><ul><li>Quetiapine </li></ul><ul><li>Risperidone </li></ul><ul><li>Ziprasidone </li></ul>
  17. 18. <ul><li>THE END </li></ul>