Schizophrenia Phay2004

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Aysha Choudhury Safia Khan Ayomide Gdadmosi Ben
Gubby Aysha Arshi
SCHIZOPHRENIA

• Brain Morphology
• Enlarged ventricles reduces brain volume
• Worse tissue loss worse symptoms

Cannot distinguish fantasy from reality
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Negative Symptoms

• Emotes less
• Rejects social gatherings
• Stops hobbies
• Neglects hygiene

More burden on others, responds less to
medication than positive symptoms.
When I was in a severe state as a student, I
would talk to my friends once a week, if that.
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Positive Symptoms

• Delusions
• (False beliefs)

• .. of Paranoia
• .. of Reference
• .. Somatic (bodily)
• .. of Grandeur

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Positive Symptoms

• Disorganised
• speech
• Skips subject-subject
• Unrecognisable terms
• Rambling monologues
• Sensory
• Hallucinations
• 10 x risk of homicide
• Abnormal (motor)
• behaviour
• Rigid limbs, bizarre posture for hours/days
• Non-responsive while awake (catatonia)

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Diagnosis
At least 2 present over 6 months
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Treatments
Non-drug

• Atypical examples
• Clozapine
• Olanzapine
• Risperidone

Antipsychotics

• Typical examples
• Chlorpromazine
• Trifluoperazine
• Haloperidol

Side Effects
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Non-drug approaches

• Family therapy
• Understand Schizophrenia
• How to solve problems
• in the home
• Cognitive Behavioural
• Therapy
• Recognise hallucinations
• e.g. Learn to ignore demons
• telling them to harm others
• Art therapy
• Alleviates negative symptoms
• e.g. Depression

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Drug Trial Process
How are antipsychotic drugs selected What
factors need to be considered?
If unsuccessful...
Stevens-Johnson Syndrome
CONTRA-INDICATION Of CLOZAPINE
e.g. Risperidone can cause Insomnia (SE)
e.g. Diazepam (sedating)treats insomnia Or..
Consider Contra-indications/ Interactions?
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Side Effects
Akathisia ..difficult to sit still and stop
moving
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Side Effects
Ease off after body becomes accustom to medication
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Hyperprolactinaemia
Commonly

• Symptoms in women
• Irregular periods
• Production of breast milk
• Excess facial hair

Exception 2nd gen Aripiprazole (Partial
AGONIST of receptors)

• ... in men
• Loss of libido
• Decreased muscle mass
• Breast enlargement
• (gynaecomastia)

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Monitoring Health Parameters
Antipsychotic medication increases the risk of
developing cardiovascular diseases such as
hypertension, heart disease, type II Diabetes.

• Before treatment, take baseline
• measurements of
• ...take readings again 3 MONTHS
• after starting or switching antipsychotics
• ... and annually thereafter.

If elevated, they put the patient at risk
of cardiovascular disease ... medication may need
to be lowered/changed or discontinued.
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REFERENCES
Pathology http//www.ncbi.nlm.nih.gov/pmc/articl
es/PMC2416751/ Symptoms http//www.nhs.uk/Condi
tions/Schizophrenia/Pages/Symptoms.aspx
Diagnosis http//www.mayoclinic.org/diseases-c
onditions/schizophrenia/basics/tests-diagnosis/con
-20021077 Side effects http//stahlonline.cambr
idge.org/essential_4th_chapter.jsf?pagechapter5_s
ummary.- htmnameChapter205titleSummary -
http//www.patient.co.uk/health/antipsychotic-medi
cines - http//www.hormone.org/questions-and-answ
ers/2010/hyperprolactinemia Treatments
http//www.nhs.uk/Conditions/Schizophrenia/Pages/t
reatment.aspx Monitoring http//www.leicspart.n
hs.uk/