biological therapies for schizophrenia Flashcards
what are the biological therapies for schizoprenia?
- typical antipsychotics
- atypical antipsychotics
what are typical antipsychotics?
- drugs such as Chlorpromazine have been around since the 1950s
- they work by acting as antagonists in the dopamine system and aim to reduce the action of dopamine
- they are strongly associated with the dopamine hypothesis
how do dopamine antagonists work?
- block the dopamine receptors in the synapses in the brain, reducing the action of dopamine
- initially dopamine levels build up after taking Chlorpromazine, but then production is reduced
- this normalises neurotransmitters in the brain which, in turn, reduces symptoms like hallucinations
what is interesting about the antipsychotic Chlorpromazine?
has an effect on the histamine receptors which appears to have a sedation effect; as such, Chlorpromazine is used to calm anxious patients when they are first admitted to hospital
what are atypical antipsychotics?
- atypical antipsychotics such as Clozapine have been used since 1970s
- the aim of these drugs was to maintain or improve upon the effectiveness of drugs in suppressing psychoses such as schizophrenia and also minimising the side effects
- they typically target a range of neurotransmitters including dopamine and serotonin
how does Clozapine an atypical antipsychotic work?
- Clozapine binds to dopamine receptors in the same way that Chlorpromazine does but, in addition, acts on serotonin and glutamate receptors
- this drug was more effective than typical antipsychotics
- Clozapine improves mood and reduces depression and anxiety in patients as well as improving cognitive functioning
what is Risperidone?
developed atypical antipsychotic because Clozapine was involved in the deaths of some patients from a blood condition called agranulocytosis
explain how Risperidone is as effective as Clozapine but safer
- Risperidone like Clozapine, binds to dopamine and serotonin receptors
- however Risperidone binds more strongly to dopamine receptors and is therefore more effective in smaller doses than most antipsychotics and has fewer side effects
what are the evaluation points for typical and atypical antipsychotics
- likelihood of side effects
- theoretical objection to the use of antipsychotic drugs
- antipsychotic drugs may simply be a ‘chemical cosh’
- biological therapies may be more desirable than psychological therapies
explain how there is likelihood of side effects
- typical antipsychotics are associated with dizziness, agitation, sleep deprivation and weight gain for example
- long-term effects can also lead to grimacing and lip smacking as a result of dopamine hypersensitivity
- what’s worse is Clozapine was involved in the deaths of some patients from a blood condition called agranulocytosis
- even though atypical antipsychotics were developed to reduce side effects, some still exist and this is a serious limitation of anti-psychotic drug therapies
explain the theoretical objection to the use of antipsychotic drugs
- use of these drugs is closely tied up with the dopamine hypothesis and the idea that there are higher than usual levels of activity in the subcortex in the brain
- however, there is evidence to show that this may not be correct and in fact, dopamine levels in other areas of the brain are too low and not too high
- if that is true, antipsychotics shouldn’t work
- this has undermined the faith of some people that antipsychotics do in fact work
explain how antipsychotic drugs may simply be a ‘chemical cosh’
- it is widely believed that antipsychotics have been used in hospital situations to calm patients and make them easier for staff to work with, rather than benefit the patients themselves
- although short-term use of antipsychotics to calm patients is recommended by NICE, this practice is seen by some as human rights’ abuse
- this raises ethical issues in the use of antipsychotic drugs with schizophrenia patients
explain how biological therapies may be more desirable than psychological therapies
- all the psychological therapies for schizophrenia aim to make it more manageable and improve quality of life: CBT helps patients to make sense of their symptoms, family therapy reduces the stress of living with schizophrenia and token economies help to make patients’ behaviour more socially acceptable
- these things are all worth doing but whilst biological therapies also do not cure schizophrenia, they do reduce the severity of the symptoms and thus biological therapies may be the more desirable option
