biological therapy

Question 1

what is a typical anti-psychotic?

Answer 1

-traditional antipsychotic

Question 2

how do typical anti-psychotics work?

Answer 2

-as dopamine antagonists (reduce the action of dopamine)

Question 3

what symptoms do typical anti-psychotics try to combat?

Answer 3

-positive symptoms such as hallucinations and thought disturbances which are products of overactive dopamine systems

Question 4

true or false? atypical anti-psychotics came first, followed by typical anti-psychotics

Answer 4

false
typical antipsychotics came first

Question 5

what symptoms do atypical anti-psychotics try to combat?

Answer 5

-both positive and negative
-combat positive symptoms but have claimed to have some beneficial effects on negative symptoms (cognitive impairment) as well

Question 6

true or false? antipsychotics only really work on positive symptoms

Answer 6

false
atypical antipsychotics have been said to work well on negative symptoms too

Question 7

what neurotransmitters do typical antipsychotics target?

Answer 7

dopamine

Question 8

what neurotransmitters do atypical antipsychotics target?

Answer 8

dopamine, serotonin, and some work on glutamate too.

Question 9

Give an example(s) of a typical antipsychotic?

Answer 9

-chlorpromazine

Question 10

Give an example(s) of an atypical antipsychotic?

Answer 10

-clozapine
-risperidone

Question 11

What type of antipsychotic is chlorpromazine?

Answer 11

typical

Question 12

when was chlorpromazine introduced?

Answer 12

1950s

Question 13

how does chlorpromazine work?

Answer 13

blocks dopamine receptors in synapses of brain, reducing action of dopamine
-this normalizes neurotransmissions in key areas of the brain, reducing symptoms like hallucination

Question 14

what is the problem with chlorpromazine?

Answer 14

-when initially taking it levels of dopamine build up
-has sedative effects therefore is used to calm hospital patients

Question 15

What type of antipsychotic is clozapine?

Answer 15

atypical

Question 16

when was clozapine introduced?

Answer 16

1960s-1970s

Question 17

how does clozapine work?

Answer 17

-binds to dopamine receptors, but also acts on serotonin and glutamate receptors
-believed that this action helps improve mood and reduce depression and anxiety in patients, and improve cognitive functioning

Question 18

what is the problem with clozapine?

Answer 18

-potentially fatal side effects, especially in those with blood conditions
-high dosage required (300-450mg a day) which increases risk of side effects

Question 19

how is clozapine an improvement from the previous antipsychotic?

Answer 19

-targets more neurotransmitters, has more beneficial effects

Question 20

What type of antipsychotic is risperidone?

Answer 20

atypical

Question 21

when was risperidone introduced?

Answer 21

1990s

Question 22

how does risperidone work?

Answer 22

-binds to dopamine and serotonin receptors

Question 23

how is risperidone an improvement from the previous antipsychotic?

Answer 23

-lower dosage (4-8mg)
-binds more strongly to dopamine receptors
-fewer side effects than other antipsychotics

Question 24

What are the strengths of biological treatments for schizophrenia?

Answer 24

-evidence to support effectiveness

Question 25

What are the limitations of biological treatments for schizophrenia?

Answer 25

-sometimes severe side effects -contrasting evidence for effectiveness -ethical issues

Question 26

Explain the limitation of biological treatments for schizophrenia that there are potential ethical issues

Answer 26

-widely believed that antipsychotics have been used in hospital situations to calm people with schizophrenia and make them easier for staff to work with, rather than for the benefits to the people themselves -could be argued that those with sz so serious they need antipsychotics may not ne in the correct state of mind to give fully informed consent -this limits biological treatments

Question 27

Explain the limitation of biological treatments for schizophrenia that there is high likelihood for side effects

Answer 27

-typical antipsychotics associated with side effects like dizziness, agitation, weight gain and itchy skin -long-term use can result in tardive dyskinesia, caused by dopamine sensitivity, causes involuntary facial movements such as grimacing, blinking and lip smacking -most serious side effect of antipsychotics is neuroleptic malignant syndrome, which can cause delirium, coma and death, and frequency can range to as high as 2% -this means that antipsychotics can do harm as well as good which can cause people to avoid these treatments, making them ineffective

Question 28

Explain the limitation of biological treatments for schizophrenia that there is conflicting evidence for effectiveness?

Answer 28

-Healy 2012 suggested serious flaws with evidence for effectiveness -most studies are short term effects only -some successful trials have had data published multiple times, exaggerating size of evidence base for positive effects -because antipsychotics have calming effects, it is easy to say they have a positive effect on people experiencing symptoms. this is not the same as saying they really reduce the effects of psychosis -this means that the evidence base for antipsychotic effectiveness is less impressive than it first appears

Question 29

Explain the strength of biological treatments for schizophrenia that there is research support?

Answer 29

-there is a large body of evidence to support the idea that both typical and atypical antipsychotics are at least moderately effective -Thornley 2003 reviewed studies comparing effectiveness of chlorpromazine to controls -data with a total of 1221 ppts showed chlorpromazine was associated with better overall functioning and reduced symptom severity as compared to a placebo -Meltzer 2012 found clozapine is more effective in 30-50% of treatment resistant cases where typical antipsychotics failed -this evidence strongly suggests that anti-psychotics are effective