What was covered:

•Brief review on the dopamine hypothesis of schizophrenia.

•Review on the major dopamine pathways and the pharmacological effects resulting from the blockade of the dopamine receptors at these pathways.

•Classification of antipsychotic agents

•Comparison between the typical and atypical antipsychotics based on their pharmacological actions, therapeutic uses and adverse effects

•Drugs used in bipolar disorders, with focus on lithium

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Amisulpride

Second gen, antagonist at D2/D3

Selective effect to mesolimbic and less on nigrostrial pathway

Dual action:

-high dose: blocks post-synaptic D2 receptors at mesolimbic region

-low dose: ​blocks pre-synaptic D2 receptors at mesocortical region

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Thiazide decreases Na+ excretion at the distal tubule -->creates Na+ deficit

--> increase resorption of Na+ and Li+ at the PCT

Lithium and thiazide interactions

Renal adverse effects of lithium

• Diabetis insipidus: Chronic lithium ingestion can lead to resistance to ADH, resulting in polyuria and polydipsia. Lithium enters the principal cells of the collecting duct, then accumulates in these cells and interferes with the ability of ADH to increase water permeability

• Other nephrotoxic effects of lithium are not well understood

Antipsychotics self study

https://edpuzzle.com/open/zogtamb