Dopamine Pathways
Which pathway’s dopamine excess causes positive symptoms?
What is Mesolimbic (↑ DA)
Name one perinatal or birth-related risk factor for schizophrenia.
What is hypoxia, perinatal adversity, birth complications.
How many symptoms are required in the 1-month active phase?
What are at least 2; one must be delusions, hallucinations, or disorganized speech.
Name two first-generation antipsychotics ( brand and generic).
What is Haloperidol (Haldol®),Chlorpromazine (Thorazine®),Fluphenazine (Prolixin®), Trifluoperazine (Stelazine®), Thiothixene (Navane®)
Which SGA carries the highest metabolic risk?
What is Olanzapine (Zyprexa®)
Which population carries a class-wide BBW for ↑ mortality when using antipsychotics?
What is Elderly with dementia-related psychosis
Which pathway’s dopamine deficiency causes negative & cognitive symptoms?
What is Mesocortical (↓ DA)
What season of birth is linked to higher schizophrenia risk?
What is late winter/early spring.
What is the minimum total duration for a schizophrenia diagnosis?
What is ≥ 6 months (includes prodrome/residual).
Name two second-generation antipsychotics.
What is Risperidone — Risperdal®,Olanzapine — Zyprexa®,Quetiapine — Seroquel® / Seroquel XR®,Ziprasidone — Geodon®,Aripiprazole — Abilify®,Paliperidone — Invega®,Asenapine — Saphris®, Iloperidone — Fanapt®,Lurasidone — Latuda®,Cariprazine — Vraylar®,Brexpiprazole — Rexulti®,Lumateperone — Caplyta®,Xanomeline/trospium — Cobenfy®,Clozapine — Clozaril®
Which drug requires REMS due to agranulocytosis?
What is Clozapine (Clozaril®)
Which antipsychotic is Pregnancy Category B?
What is Lurasidone (Latuda®)
Which pathway blockade causes EPS?
Nigrostriatal
Name two substances that can mimic psychosis and must be ruled out.
What is PCP, LSD, methamphetamine, synthetic cannabinoids.
Which criteria specifies social/occupational dysfunction?
What is criterion B
Starting dose for risperidone in acute psychosis?
What is 1–2 mg/day; usual 1–6 mg/day
What did the CATIE trial conclude about olanzapine vs other SGAs?
What is Olanzapine had longer time to discontinuation; clozapine best for TRS.
Which antipsychotics have highest EPS risk?
What is Paliperidone (Invega®) and Risperidone (Risperdal®)
Which pathway blockade causes ↑ prolactin?
What is Tuberoinfundibular.
Which medical conditions should be ruled out before diagnosing schizophrenia?
What is thyroid disease, CNS tumor/stroke, B12 deficiency, HIV, syphilis, delirium/dementia.
Which disorders must be ruled out under DSM-5 Criterion D?
What are schizoaffective and mood disorders.
What’s the dose of olanzapine?
What is 2–5 mg QHS; target 10–20 mg/day (max 20). Acute IM Q2–4h available
Which SGAs are weight-neutral options?
What are Aripiprazole(Abilify®), ziprasidone(Geodon®), lurasidone(Latuda®), lumateperone(Caplyta®),Asenapine (Saphris®) .
Which antipsychotic is most effective for treatment-resistant schizophrenia and suicidality?
What is Clozapine (Clozaril)
How do FGAs vs SGAs differ in their effects on dopamine pathways?
What is FGAs: strong D₂ block → treat positive but ↑ EPS/prolactin, may worsen negative/cognitive; SGAs: D₂ + 5-HT₂A antagonism → less EPS, may help negative symptoms, but more metabolic AEs.
Name 3 non-genetic risk factors for schizophrenia
What are urban upbringing, paternal age, perinatal complications, seasonal birth.
What special rule applies if pervasive developmental disorder is present?
What is schizophrenia can only be diagnosed if prominent delusions/hallucinations are present ≥1 month.
Which SGA has multiple LAI formulations (monthly to every 6 months)?
What is Paliperidone (Invega® Sustenna®, Trinza®, Hafyera®).
Which SGA must be taken with food, and which one with a fatty meal specifically?
What is Lurasidone (Latuda®) with food and Ziprasidone (Geodon®) with fatty meal
Which options are best for children/adolescents to minimize metabolic/EPS risk?
What are Weight-neutral choices like Aripiprazole (Abilify®), Ziprasidone (Geodon®), Lurasidone (Latuda®), and Asenapine (Saphris®)?