Biological therapies for SZ

Question 1

What are the 2 categories for antipsychotics?

Answer 1

typical - developed 1950s
Atypical - developed in last 20 years

Question 2

What are typical antipsychotics?

Answer 2

work as dopamine antagonists such as Chlorpromazine

Question 3

How do typical antipsychotics work?

Answer 3

• bind to dopamine receptor
• don’t trigger a postsynaptic response
• effective in controlling positive symptoms (also anxiety and agitation)

Question 4

What are atypical antipsychotics?

Answer 4

target neurotransmitters serotonin and dopamine
such as Clozapine Risperidone

Question 5

How do atypical antipsychotics work?

Answer 5

block D2 receptors temporarily (thought to lead to less side effects)

Question 6

Who invesitgated into the effectiveness of antipsychotics?

Answer 6

Leucht et al (2012)

Question 7

What did Leucht et al (2012) find?

Answer 7

Meta analysis of 65 studies 1959-2011
Within 12 months, 64% placebo patients had relapsed
27% of those who stayed on the antipsychotic relapsed

Question 8

What is the most effective drug?

Answer 8

Meltzer (2012) … CLOZAPINE !!!!!!!
Lewis and Lieberman (2008) large trials and Clozpaine was the best :]

Question 9

But are drugs the most appropriate therapy?

Answer 9

Side effects :(
Tardive Dyskinesia (can affect 20% patients and can be permanent) Typical
Nueroleptic Malignant syndrome can be fatal - typical

Atypical better - TD 5% cases (Jeste et al 1999)
agranulocytosis 0 lowered white blood cells

Question 10

But are one or the other better?

Answer 10

Crossley et al (2010)
reviewed efficacy (capacity to reduce symtpoms)
and side effects
found no signifcant difference

Question 11

What are motivational deficits?

Answer 11

ross and read (2004)
medication enforces there is ‘something wrong with you’