Psychotic Disorders.ppt


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Psychotic Disorders.ppt

  1. 1. Psychotic Disorders PSYC 689: Psychopharmacology 4/19/06
  2. 2. What are psychotic disorders? <ul><li>Disorders that feature: </li></ul><ul><li>Failures of reality testing </li></ul><ul><li>Creation of new realities </li></ul><ul><li>- Delusions </li></ul><ul><li>- Hallucinations </li></ul>
  3. 3. Causes for Psychotic Disorders <ul><li>Genetic Predisposition </li></ul><ul><li>Drug Use/Abuse </li></ul><ul><li>Medical Conditions </li></ul>
  4. 4. Genetic Predisposition <ul><li>Twin Studies – higher concordance rate for identical twins vs. fraternal twins </li></ul><ul><li>Adoptive Studies </li></ul><ul><li>Gene Mutations (e.g. the D4 receptor gene) </li></ul>
  5. 5. Drug Use/Abuse <ul><li>Hallucinogenic drugs are capable of producing features of psychotic disorders in people who normally do not show symptoms of these disorders </li></ul><ul><li>Other drugs that have been linked to higher risk of developing psychotic disorders include psychostimulants (e.g. ephedra and cocaine) and industrial inhalants (e.g. nitrous oxide). </li></ul>
  6. 6. Medical Conditions <ul><li>Some medical conditions can induce psychotic episodes. </li></ul><ul><li>These medical conditions can include organ failures (e.g. renal failure), head injuries, and degenerative diseases like Alzheimer’s and Parkinson’s. </li></ul>
  7. 7. Historical Perspectives <ul><li>People in antiquity (e.g. Egyptians, Greeks, and Romans) considered the heart and mind to be strongly connected. </li></ul><ul><li>Most mental disorders (e.g. depression, anxiety disorders, psychotic disorders) were treated in the same manner. </li></ul><ul><li>Differential treatment was used in the Middle Ages depending upon the social and political alignment of the person with a psychotic disorder. </li></ul>
  8. 8. Modern Psychological Research <ul><li>Neurological and Neuroimaging studies that look at the brains of psychotic disorder patients show </li></ul><ul><li>- Less activity in the prefrontal cortex for patients with psychotic disorders vs. control subjects </li></ul><ul><li>- Larger ventricles for schizophrenic patients vs. controls </li></ul><ul><li>- Stronger activity in right hemisphere during language production and interpretation. </li></ul>
  9. 10. Left: Brain of a healthy control subject Right: Brain of a schizophrenic patient
  10. 11. fMRI scan of Schizophrenic patient having an auditory hallucination
  11. 12. Computational Modeling Research <ul><li>Data gathered from neurological research can be re-constructed in computational models. </li></ul><ul><li>Advantage: Allows researchers to experiment with treatment methods without potentially harming people. </li></ul><ul><li>Disadvantage: Requires initial conditions from humans to set the parameters of the program. </li></ul>
  12. 13. Treatment Methods <ul><li>Non-pharmacological Treatments </li></ul><ul><li>Antipsychotic Medications </li></ul><ul><li>Atypical Antipsychotic Medications </li></ul>
  13. 14. Non-Pharmacological Treatments <ul><li>Psychosurgery (e.g. Lobotomy) </li></ul><ul><li>Electro-convulsive Therapy (ECT) </li></ul>
  14. 15. Antipsychotic Medications <ul><li>Most early Antipsychotic Medications worked on the Dopamine Model of Psychotic Disorders </li></ul><ul><li>Act to block Dopamine receptors, specifically D2 receptors. </li></ul><ul><li>Problem lies in side effects. Strong dopamine blockers also block the dopamine necessary for smooth, un-interrupted muscle movement (e.g. tardive dyskenesia) </li></ul><ul><li>Other side effects include dizziness, sedation, difficulty urinating or constipation, and sexual dysfunction. </li></ul><ul><li>Chlorpromazine (Thorazine) was the first of these developed in 1952, but thiothixene (Navane), haloperidol (Haldol), loxapine (Loxatane), molindone (Moban), pimozide (Orap) are also examples of this type of medication. </li></ul>
  15. 16. Atypical Antipsychotic Medications <ul><li>Typically weaker D2 blockers than traditional Antipsychotic Medications, these medications also strong blockers of Serotonin receptors (specifically, 5-HT2A and 5-HT2C) </li></ul><ul><li>Side effects from these medications can include weight gain, some extrapyramidal effects (e.g. slowed movements, shuffling gait), and sedation. </li></ul><ul><li>Clozapine, risperidone (Risperdol), olanzapine (Zyprexa), quetiapine (Seroquel), ziprasidone (Geodon), and aripipazole (Amblify) </li></ul><ul><li>Effects in both traditional and atypical antipsychotic drugs vary from drug to drug. </li></ul>
  16. 17. Conclusions <ul><li>Psychotic Disorders can be caused by a wide variety of sources (Genetics, Substance Use/Abuse, Medical Conditions) </li></ul><ul><li>Research on these disorders has revealed some predictable patterns (e.g. computational modeling) and unique brain pathology. </li></ul><ul><li>Medication for treating psychotic disorders is still relatively new and can trigger a variety of side effects that could lead people to discontinue use of the medication. </li></ul>