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Showing posts with the label Schizophrenia

Differences between Typical and Atypical Antipsychotics: Efficacy and Adverse Effects

Typical Versus Atypical Antipsychotics By definition, typical antipsychotics are those which produce extrapyramidal side effects, while atypical antipsychotics do not. However, at the doses used today, most atypical antipsychotics do not produce extrapyramidal side effects. Whether typical and atypical antipsychotics differ in efficacy in a long-held debate. Except for clozapine, there are no significant differences in the efficacy of typical and atypical antipsychotics.  Two large pragmatic studies, CATIE  in the United States, and CutLASS  in the United Kingdom, in 2005 and 2006, respectively, produced similar conclusions. Another meta-analysis, in 2009 showed that risperidone, olanzapine, and amisulpride were more effective compared to typical antipsychotics.  Overall, typical antipsychotics are more likely to produce extrapyramidal side effects, while atypical ones are more likely to produce metabolic side effects, including weight gain, hyperlipemia, and diabetes.  Clozapine is mo

Verbigeration

Verbigeration Verbigeration is the monotonous repetition of syllables and words,  like perseveration--in which a person repeats words in response to a stimulus. However, verbigeration occurs when a person repeats words without a stimulus.  It is an extreme form of loosening of associations.    We observe it in organic disorders.

Age Disorientation in Schizophrenia

Age Disorientation in Schizophrenia Age-disoriented patients are cognitively more impaired than their age-oriented counterparts. Whether the cognitive impairment is present to a greater degree premorbid among these patients, studies have not yet established this, but some data support this. Others have reported that rated school performance and grade-level do not distinguish age-disoriented from age-oriented subjects. Some have suggested that marked cognitive decline occurs following the first break.  Harvey et al. reported that age-related decline in mini-mental state examination scores is dramatically greater among age-disoriented schizophrenia patients than age-oriented subjects, consistent with more rapid deterioration. Examination of the specific PANSS items revealed that the age-disoriented group was consistently more delusional and more conceptually disorganized and showed increased stereotyped thinking, motor retardation, unusual thought content, disorientation, and poor attent

The Gene associated with antisocial behaviour

Criminal behavior, lack of guilt, and irritability are typical features of antisocial personality disorder. Evidence suggests that a low-activity variant of the MAO-A gene predisposes to adult antisocial behavior in men, especially in those who faced early adversity 1–4 . Catechol-O-methyltransferase enzyme metabolizes dopamine and other monoamines. Its gene, the COMT-gene, occurs in two forms: a high-activity form and a low-activity form. They associate these variants with differential abilities of the prefrontal cortex, especially working memory. People with low-activity form may have a more efficient prefrontal cortex, likely because of the greater dopamine level in the synaptic space 5,6 . We have associated serotonin transporter gene variants with neuroticism and a predisposition to depression. The variants may also influence individual response to SSRIs8. APOE4 gene is a risk factor for Alzheimer’s disease (compared to APOE2 and APOE3).

Components and Principles of management of schizophrenia Mnemonic

What are the components and principles of management of schizophrenia ?  Answer: MENOMONIC -> CONFIATE CBT , c ognitive remediation, c lozapine, c risis resolution teams. O utreach teams  N eeds assessment  F amily intervention I ntegrated treatment for comorbid substance abuse A ntipsychotics T herapeutic realtionship  E arly intervention