Biological Therapies

Question 1

What are typical antipsychotics?

Answer 1

• These are dopamine antagonists
• The drug bind to dopamine receptors and work by blocking them, this reduced the stimulation of dopamine, so positive symptoms are reduced

Question 2

What are atypical antipsychotics?

Answer 2

• Reduces the effects of dopamine and serotonin and glutamate which reduces positive and negative symptoms
• These take effect by blocking dopamine and serotonin receptors

Question 3

Describe chlorpromazine as a typical antipsychotic

Answer 3

• Can be taken as tablets, syrup or injection
• Blocks D2 receptors, so reduces positive symptoms and can be used to calm patients
• Studies show better functions and reduced symptoms with drug than placebo
• It may cause dizziness, tardive dyskinesia and more

Question 4

Describe clozapine as an atypical antipsychotic

Answer 4

• Daily dosage is lower than chlorpromazine
• Treats both negative and positive symptoms as it acts on dopamine and glutamate, so improves cognitive functions and reduced depression
• It’s effective in 30-50% of cases where chlorpromazine has failed
• Has fatal side effects, can lead to a blood condition (agranulocytosis)

Question 5

Describe risperidone as an atypical antipsychotic

Answer 5

• It has a very small dose
• Treats both negative and positive symptoms as it binds to serotonin and dopamine receptors, which has a similar effect to clozapine.
• Has fewer side effects than clozapine as it’s taken in smaller doses

Question 6

Give evaluation for drug therapies (side effects may not be completely appropriate)

Answer 6

• Typical antipsychotics can cause tardive dyskinesia, which is uncontrollable movements, around 30% of patients taking typical antipsychotics develop TD
• However, atypical antipsychotics were developed to reduce the side effect and has generally succeeded. But, clozapine has been liked to the deaths of SZ patients who developed a blood condition (agranulocytosis)
• Questions the appropriateness of drug therapy as it may not suitable for all and could be harmful to patients

Question 7

Give evaluation for drug therapies (how the drugs work in unclear)

Answer 7

• Drugs only treat the symptoms of SZ, but not the cause.
• Antipsychotics can’t seek out and eliminate the cause of SZ, and work by only helping in reducing the symptoms.
• Moreover, according to the revised dopamine hypothesis, with low levels of dopamine in some brain areas being the cause, antipsychotics shouldn’t work
• Suggests that antipsychotics may not be completely effective as a treatment it doesn’t tackle the cause, and symptoms will return if drugs are stopped.

Question 8

Give evaluation for drug therapies (research support for effectiveness of drug therapy)

Answer 8

• Leucht et al’s metanalysis compared relapse rates for anti-psychotics and placebos. Some patients taken off their meds and given placebo instead. They found within year, 64% of those given placebos relapses compared to 27% given anti-psychotics
• Shows the superiority of antipsychotics drugs compared to placebo in preventing relapse.