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Key Neurotransmitters, Schizophrenia - Coggle Diagram

- - - - inhibits AChE making more ACh available, compensating in part for the symptoms of dementia in memory
- - - - Think:
        Drive
        psychOsis
        Parkinsonism
        Attention
        Motor
        Inhibition (prolactin)
        Narcotics
        Extrapyramidal
        
        Mesolimbic pathway (reward/motivation)
        
        Too little: depression, negative symptoms of schizophrenia, thought to be involved in ADHD symptoms (executive function)
        
        Too much: psychosis symptoms, symptoms of drug intoxication
        
        Schizophrenia
        
        Antipsychotics
        
        Aripiprazole: partial Dopamine agonist, thought to decrease dopamine concentrations when high, and increase when concentrations are low
        
        Dopamine antagonist, reducing positive symptoms of schizophrenia. some antagonist action at serotonin receptors thought to improve negative symptoms
        
        Nigrostriatal pathway (stop/go or motor)
        
        Too Little
        
        Parkinsons
        
        Dopamine Agonists: pramipexole, rotigotine work to mimic action of dopamine
        
        Carbidopa-levidopa: converted to dopamine by striatal enzymes in the brain (levidopa) and prevents degradation of degradation of dopamine/levidopa (carbidopa)
        
        Too Much: Huntington's symptoms, Tics (Tourettes), Tardive dyskinesia
        
        Tics (Tourettes)
    - - too little: depression, ADHD
  - - - Alterations
        
        Too little release
        
        ADHD
        
        Stimulants (methylphenidates, amphetamine preparations)
        
        increases norepinephrine and dopamine in the frontal cortex by blocking reuptake
        
        Amphetamine preparations also facilitate release of dopamine and norepinephrine and therefore may contribute to side-effects of stimulants
        
        Methylphenidates do not facilitate additional release of dopamine and norepinephrine and work only at the reuptake sites
        
        Nonstimulants: norepinephrine uptake inhibitor
        
        blocks norepinephrine reuptake pumps, which increases norepinephrine transmission. Also allows additional dopamine transmission due to the action of norepinephrine pumps in degradation of dopamine in the frontal cortex
        
        Alpha agonists (Guanfacine, clonidine)
        
        Works on post-synaptic Alpha 2 (inhibitory norepinephrine) receptors in prefrontal cortex, thus enhancing norepinephrine action
        
        Too much
        
        Mania in Bipolar disorder
    - - Fight or flight reaction (autonomic reactivity including sweating, chills, nausea, palpitations, dyspnea)
      - Final product of Sympathetic neurons of ANS
      - A1, B1: excitatory receptors
      - A2, B2: Inhibitory receoptors
  - - - Low activity of post-synaptic receptors
        
        Anxiety
        
        Treatment
        
        TCAs
        
        boosts noradrenergic neurotransmission, including dopamine, higher doses may boost serotonergic transmission
        
        SNRIs
        
        increases serotogenergic and noradgrenergic transmission.
        
        May increase dopamine dopamine neurotransmission
        
        Regulates amount of norepinephrine (down) and serotonin (up)
        
        SSRIs
        
        increases serotogenergic transmission
        
        increase circulating serotonin by blocking reuptake
        
        Benzodiazepines (second line) enhance inhibitory effects of GABA
      - depletion of serotonin
        
        Depression (unipolar and bipolar)
    - - Pineal gland, Pons
      - Important to limbic system (emotion, mood, hunger, sex, instincts, sleep)
    - - Head: satisfaction, sociality, migraines, anxiety, impulsivity, sex drive
      - Red: Platelets, bleeding
      - Fed: GI motility, nausea / Dead: (serotonin syndrome) 2-12% mortality
    - - Serotonin syndrome
        
        agitation/restlessness, insomnia, confusion, loss of muscle coordination, diarrhea, HA, seizure
- - - - Generates somnolence/decreased alertness, decreases anxiety and muscle tension, decreases memory