biological therapy Flashcards
what are the typical antipsychotics
-since the 1950s
-tablets, syrup or by injection.
Orally administered daily doses are up to a maximum of 1000mg daily. Initial doses are smaller and gradually increased to a maximum of 400-800mg.
what are dopamine antagonists
-(antagonists= chemicals that reduce the action of a neurotransmitter), they block dopamine receptors in the synapses of the brain, reduces the levels of dopamine.
-Initially, the amount of dopamine increases when the patient first starts taking them but then its production is reduced.
what does the dopamine hypo state
-antagonist effect normalises transmission in key areas of the brain, reducing symptoms like hallucinations.
how is chlorpromzine a sedative
-due to its effect on histamine receptors.
- calm patients with other disorders, often hospitals do this when a patient first arrives.
-Syrup is absorbed faster so is given when chlorpromazine is used for its sedative properties.
what are atypical antipsycholtics(clozapine)
-maintain and improve the effectiveness of drugs whilst reducing the side effects.
-developed in the 1960’s and withdrawn in the 1970”s after some patient deaths from a blood condition called agranulocytosis.
- reintroduced in the 1980s when it was found to be more effective than typical antipsychotics. Used today when other treatments fail and patients must have regular blood tests to check for the development of agranulocytosis.
key features of atypical antipsychotics
treat the dopamine, but block serotonin receptors in the brain too.
-not available as an injection because of its potentially fatal side effects.
- Daily dosage at 300-450 mg a day.
how does clozapine work
-binds to dopamine receptors
- acts on serotonin and glutamate receptors.
-helps improve mood and reduce depression and anxiety in patients, it may improve cognitive functioning.
-sometimes prescribed when a patient is considered a high suicide risk (30-50% of people suffering from SZ attempt suicide at some point).
use of atypical antipsyhtoics (risperidone)
-less side effects then clozapine.
It has been used since the 1990s.
-Can be taken as tablets
-daily dose starts at 4-8mg up to a maximum of 12mg).
-Can also be taken as a syrup or by injection which lasts 2 weeks.
how does risperidone work
-binds to dopamine and serotonin receptors like Clozapine.
-binds more strongly to dopamine receptors than Clozapine and so is more effective in much smaller doses
-Evidence suggests this leads to less side effects than the normal antipsychotic.
strengths of bio therapy
(evidence for effectiveness)
Typical Antipsychotics: Thornley et al. (2003) reviewed 13 trials (1,121 participants) comparing Chlorpromazine to a placebo. Results showed that Chlorpromazine led to better overall functioning and reduced symptom severity.
Atypical Antipsychotics: Meltzer (2012) found that Clozapine is more effective than both typical and other atypical antipsychotics, particularly in treatment-resistant cases, where it benefits 50% of patients who did not respond to typical antipsychotics.
weakness of bio therapy for sz
(cp to effectiveness)
Healy (2012)- Most studies are of short-term effects only and some successful trails have had their data published multiple times, exaggerating the size of their positive effects .
-Because antipsychotics have powerful calming effects. It is easy to demonstrate that they have had some positive effect on people experiencing the symptoms of Schizophrenia. This is not the same as reducing the severity of psychosis.
-less impressive than it first appears.
(serious side effects)
typical Antipsychotics: Common side effects include dizziness, agitation, sleepiness, stiff jaw, weight gain, and itchy skin.
Long-term Use Risks: Can lead to tardive dyskinesia, caused by dopamine supersensitivity, resulting in involuntary facial movements (grimacing, blinking, lip smacking).
Most Serious Side Effect – Neuroleptic Malignant Syndrome (NMS):
Caused by dopamine blockage in the hypothalamus (which regulates body functions).
Symptoms: High temperature, delirium, coma—can be fatal.
(mechanism unclear)
-dopamine hypothesis states that high levels of dopamine cause SZ
-contradicted by evidence that shows some dopamine levels in parts of the brain other than the sub cortex are too low (rather than too high!)
-create issues for the use of antipsychotics because it is unclear how antipsychotics (dopamine antagonists) can help with schizophrenia when they reduce dopamine activity.
-Therefore, many believe that antipsychotics do not work.
(chemical cosh)
Rather than curing symptoms, they induce a calm, zombie-like state.
Unethical as they control behavior, reducing personal autonomy.
Necessary in some cases to prevent self-harm or harm to others.
Dehumanizing, as they remove personal responsibility and may be given without proper consent.
Positive Aspect: By reducing distress from hallucinations and delusions, they help patients engage with other treatments like CBT.
how else can we argue the chemical cosh arguement
-large numbers of people with learning disabilities are being prescribed strong psychiatric drugs, possibly as a “chemical cosh” to quieten those with challenging behaviour.
-number of people registered with GP practices with an intellectual or learning disability, who are being treated with psychotropic drugs far exceeds those with mental illness (British Medical Journal).
-drugs are used to control their behaviour. This is seen as human rights abuse (Moncrieff, 2013).
