Ursula has an organic brain disorder that causes aggression, anxiety, and sleeplessness. She explains to her doctor, “I

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Ursula has an organic brain disorder that causes aggression, anxiety, and sleeplessness. She explains to her doctor, “I feel like my engines are always revving. I don’t get super-hyper; I am super-hyper, like all the time.” In addition to anxiety, panic attacks, and insomnia, episodes of paranoia cause Ursula’s bouts of aggression.
Initially, Ursula is put on an antipsychotic, but, unfortunately, Ursula develops extrapyramidal side effects, including “a lot of uncontrolled movements,” which frighten and embarrass her. Her psychiatrist identifies these as extrapyramidal side effects, and he tries lowering her dosage, to little avail.
Ursula has changed physicians and is now being treated with a different antipsychotic and is relieved to find that not only do all her symptoms fall under more control, but also the movement problems, which embarrassed her so much, have disappeared.
“Now,” she says, “my main problem is, I’m getting fat. I think it’s the new drugs. Every time I go off them, I get skinny again, but also more hyper.”
Question 1
Looking at Ursula’s history of side effects and compliance issues, (a) predict what two types of drugs she’s taken. (b) What may be causing her weight gain?
Question 2
Ursula has seen commercials on TV about a drug called Abilify. She understands that it does not cause weight gain like her current drug. (a) How is this drug’s effect on dopamine unique from the first- and second-generation agents? (b) Is Ursula correct that it is less likely to cause her weight gain?