Biological Therapies Flashcards
Antipsychotic medication
These are effective in treating the most disturbing forms of psychotic illness. They help the person function in every day like as well as possible and increase their feeling of well-being. Conventional drugs are used to combat the positive symptoms whereas atypical are used to do the same but also have an impact on negative too,
How do conventional drugs work?
They reduce the effects of dopamine and so reduce the symptoms of schizophrenia. These drugs are dopamine antagonists so they bind to dopamine receptors but them do not stimulate them thus blocking their action. By doing this they can eliminate hallucinations and delusions.
How do atypical drugs work?
They act on the dopamine system but are thought to block serotonin receptors. Kapur and Remington said that these drugs do not involve serotonin but only the dopamine system. They help by occupying the D2 receptors and then dissociating to allow normal dopamine transmission. It is this that is thought to be responsible for the lower levels of side effects.
How does ECT work?
An electric current being passed between 2 electrodes to create a seizure. An electrode is placed on the non-dominant side of the brain and another on the forehead. The person is then injected so they are unconscious and are given a nerve-blocking agent, paralysing the muscles so when the seizure occurs, the muscles do not contract. An electric current is passed through causing the seizure.
Effectiveness of conventional antipsychotics:
Relapse rates:
Davis et al found significant differences in relapse rates between groups who had a placebo drug and those who actually received the medication with every group studied. Demonstrating the effectiveness of the drug.
Effectiveness of conventional antipsychotics:
Other factors are important:
The relapse rate for those living with hostility and criticism in their home environment was 53% on medications and those on a placebo it was 92%. However, those living in a supportive home found no difference in actual and placebo drug.
Appropriateness of conventional antipsychotics:
Tardive Dyskinesia:
About 30% of people taking this medication developed the side effect tardive dyskineasia.
Appropriateness of conventional antipsychotics:
Motivational Deficits:
Ross and Read argued that being prescribed medication reinforces the idea that there is something wrong. This prevents individuals from searching for potential stressors that could trigger their condition. And so people become less motivated to look for solutions to reduce their symptoms,
Effectiveness of atypical antipsychotics:
Atypical vs Conventional:
A meta-analysis found that atypical drugs were only moderately more superior than conventional.
Effectiveness of atypical antipsychotics:
Effectiveness with negative symptoms:
This claim only has marginal support. Leucht found that 2 of the atypical drugs were ‘slightly’ more effective.
Appropriateness of atypical antipsychotics:
Lower likelihood of tardive dyskinesia:
Jeste found that out of those taking conventional drugs, 30% had tardive dyskinesia after 9 months of treatment compared to 5% taking atypical drugs.
Appropriateness of atypical antipsychotics:
Fewer side effects:
Because there are fewer side effects, people are more likely to continue with treatment and so will feel the benefits.
Effectiveness of ECT:
A review listed 19 studies that compared ECT with ‘simulated’ ECT (anesthesia but not ECT) and found that ECT produced no different results from those of antipsychotic medication. However, in an Indian study, they found no difference in symptom reduction between patients given ECT or simulated ECT.
Appropriateness of ECT:
Because of the many risks associated with ECT, the treatment is declined and has been banned for many years.
Overall Evaluation:
Ethical Issues:
If you take antipsychotic medication into account including its side effects and consequences, a cost-benefit analysis would turn out to be negative, so is it worth it?
