Two hemispheres

Frontal lobe

Parietal lobe

Temporal lobe

Occipital lobe

The cerebellum is located below the cerebrum and is the center for coordination and movements and postural adjustments

It recieves and integrated information from all areas of the body, such as muscles, joints, organs, and other components of the CNS.

Excitatory

Controls complex movemens, motiation, cognition; regulates emotional response

Excitatory

Causes changes in attention, learning and memory, sleep and wakefulness, mood

Excitatory

Controls fight or flight response

Neuromodulator

Controls alertness, gastric secretions, cardiac stimulation, peripheral allergic responses

Excitatory or inhibitory

Controls seep and wakefulnes cycle; signals muscles to become alert

Neuromodulators

Enhance, prolong, inhibit, or limit the effects of principal neurotransmitters

Excitatory

Results in neurotoxicity if levels are too high

Inhibitory

Modulates other neurotransmitters

Three types of studies are commonly conducted to investigate the genetic bases of mental illness:

1. Twin studies
2. Adoption studies
3. Family studies

Types of brain imaging techniques:

CT

A procedure in which a precise x-ray bram takes cross-sectional images (slices) layer by layer

CT can visualize the brain's soft tissues, so it is used to diagnose primary tumors, metastases, and effusions and to detrmine the size of the ventricles of the brain.

Types of brain imaging techniques:

MRI

An energy field is created with a huge magnet and radiowaves

MRI produces more tissue deatil and contast than CT and can show blood flow patterns and tissue changes such as edema.

Types of brain imaging techniques:

PET and SPECT

Radioactive substances are injected into the blood; the flow of those substances inthe brain is monitored as the client performs cognitive activities as instructed by the operator.

PET uses two photons simultaneously; SPECT uses a single photon.

Psychopharmacology:

Psychotropic drugs

Several catergories of drugs used to treat mental disorders:

Antipsychotics

Antidepressants

Mood stabilizers

Anxiolytics

Stimulants

Antipsychotic drugs:

Mechanism of action

Antipsychotic drugs:

Conventional or 1st generation

The conventional, or 1st generation antipsychotic drugs are potent antagonists of D2, D3, and D4.

Chlorpromazine (Thorazine)

Fluphenazine (Prolixin)

Thioridazine (Mellaril)

Haloperidol (Haldol)

Loxapine (Loxitane)

Antipsychotic drugs:

Atypical or 2nd generation

Relatively weak blockers of D2, which may account for the lower incidence of exrapyramidal side effects. In addition, second-generation antipsychotics inibit the reuptake of serotonin increasing their effectiveness in treating the depressive aspects of schizophrenia

 Clozapine (Clozaril)

Risperidone (Risperdal)

Olanzapine (Zyprexa)

Antipsychotic drugs:

3rd generation

These drugs are thought to stablize dopamine output; that is, they preserve or enhance dopaminergic transmission when it is too low and reduce it when it is too high.

Aripiprazole (Abilify)

Antipsychotic drugs: Side effects

Extrapyramidal symptoms (EPS)

Acute dystonia

Pseudoparkinsonism

Akathasia

Antipsychotic drugs: Side effects

Acute dystonia

Drug induced parkinsonism

Stiff stooped posture

Mask-like facies

Decreased arm swing

A shuffling, festinating gait (with small steps)

Cogwheel rigidity (rachet-like movements of joints)

Drooling

Tremor

Bradycardia

Coarse pill-rolling movements of the thumb and fingers while at rest

The major symptoms of NMS are:

• Rigidity
• High fever
• Autonomic instability such as unstable blood pressure, diaphoresis, and pallor
• Delirium
• Elevated levels of enzyme, particularly creatinine phosphokinase

Orthostatic hypotension

Dry mouth

Constipation

Urinary Hesitance or retention

Blurred near vision

Dry eyes

Photophobia

Nasal congestion

Decreased memory

Primarily used in the treatment of major depressive illness, anxiety disorders, the depressed phase of bipolar disorder, and psychotic depression

Antidepressants somehow interact with the two neurotransmitters, norepinephrine and serotonin

1. Tricyclic and the related cyclic antidepressants
2. Selective serotonin reuptake inhibitors (SSRIs)
3. MAO inhibitors (MAOIs)
4. Other antidepressants

Cyclic antidepressants and venlafaxine block the reuptake of norepinephrine primarily and block serotonin to some degree

The cyclic antidepressants block cholinergic receptors, resulting in anticholinergic effects.

Clients taking cyclic compounds frequently report sexual dysfunction

The SSRIs block the reuptake of serotonin

Enhanced serotonin transmission can lead to several common side effects such as:

Anxiety

Agitation

Akathisia

Nausea

Insomnia

Diminished sexual drive or difficulty achieving an erection or orgasm

The MAOIs interfere with enzyme metabolism

The most common side effects of MAOIs include:

Daytime sedation

Insomnia

Weight gain

Dry mouth

Orthostatic hypotension

Sexual dysfunction

*Hypertensive crisis, if the client ingests food that contains tyramine or takes sympthomimetic drugs

Nefazodone

Trazodone

Mirtazapine

Bupropion

Venlafaxine

Desvenlafaxine

Antidepressant Drugs:

Drug interaction, serotonin syndrome

Results from taking an MAOI and an SSRI at the same time. It can also occur if the client takes one of these drugs too close to the end of therapy with the other. Symptoms include:

Agitation

Sweating

Fever

Tachycardia

Hypotension

Rigidity

Hyperreflexia

In extreme reactions, even coma and death

Mood-stabilizing drugs are used to treat bipolar disorder by stabilizing the client's mood, preventing or minimizing the highs and lows that charazterize bipolar illness, and treating acute episodes of mania.

Mood-stabilizing drugs are used to treat bipolar disorder by stabilizing the client's mood, preventing or minimizing the highs and lows that charazterize bipolar illness, and treating acute episodes of mania.

Lithium is the most established mood stabilizer

First-line agent in the treatment of bipolar disorder

Serum lithium levels: 0.5 mEq/L and 1.5 mEq/L

Mild nausea or diarrhea

Anorexia

Fine hand tremor

Polydipsia

Polyuria

A metallic taste in the mouth

Fatigue or lethargy

Increases levels of the inhibitory neurotransmitter GABA

Stabilize mood by inhibiting the kindling process

Drowsiness, sedation, dry mouth, and blurred vision

Carbamazepine: Rashes and orthostatic hypotension

Valproic acid: Weight gain, alopecia, and hand tremor

Antianxiety drugs:

Mechanism of action

Benzodiaxepines have proved to be the most effective in relieving anxiety and are the drugs most frequently prescribed

Benzodiazepines mediate the actions of the amino acid GABA, the major inhibitory neurotransmitter in the brain.

Buspirone is believed to exert its anxiolytic effec by acting as a partial agonist at serotonin receptor, which decreases serotonin turnover

Physical dependence

Psychological dependence

CNS depression

Hangover effect

Tolerance

Dizziness

Sedation

Nausea

Headache

Stimulants:

Mechanism of action

Anorexia

Weight loss

Nausea

Irritability

Disulfiram is a sensitizing agent that causes an adverse reaction when mixed with alcohol in the body. This agent's only use is it acts as a deterrent to drinking alcohol. 

Disulfiram inhibits the enzyme aldehyde dehydrogenase, which is involved in the metabolism of ethanol. This reaction is potentiated by decreased levels of epinephrine and norepinephrine in the sympathetic nervous system caused by inhibition of dopamine beta hydroxylase.