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Psychology - IN FOCUS Schizophrenia > Biological therapy for schizophrenia > Flashcards

Biological therapy for schizophrenia Flashcards

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1
Q

What does the most common treatment for schizophrenia involve?

A

The use of antipsychotic drugs

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2
Q

What does the term ‘antipsychotic’ refer to?

A

Psychosic

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3
Q

What does a person with psychosis experience?

A

Some loss of contact with reality

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4
Q

Give an example of how a person with psychosis may experience some loss of contact with reality

A

Through hallucinations or delusions

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5
Q

Psychosis is a defining characteristic of what?

A

Schizophrenia and related disorders

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6
Q

True/False: Antipsychotics are always required in the long term when treating schizophrenia

A

False, they can be required in the short or long term

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7
Q

True/False: Some people with schizophrenia can take a short course of antipsychotics then stop their use without the return of symptoms

A

True

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8
Q

Why may some people with schizophrenia require antipsychotics for life?

A

Otherwise they face the likelihood of a recurrence of schizophrenia’

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9
Q

Antipsychotics can be divided into how many types of drugs?

A

2

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10
Q

What are the two types of antipsychotic drugs called?

A

Typical and atypical

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11
Q

Typical antipsychotics have been around for how long?

A

Since the 1950s

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12
Q

Chlorpromazine is a(n) typical/atypical antipsychotic

A

typical

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13
Q

How is chlorpromazine taken?

A

As tablets, syrup or by injection

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14
Q

If taken orally, chlorpromazine is administered daily up to a maximum of how many milligrams?

A

1000

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15
Q

If taken orally, chlorpromazine is administered how frequently up to a maximum of 1000mg?

A

daily

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16
Q

When prescribed chlorpromazine to treat schizophrenia, initially doses are larger/smaller

A

smaller

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17
Q

When prescribed chlorpromazine to treat schizophrenia, for most people the dosage is gradually increased to a maximum of ___ to ___mg

A

400 to 800

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18
Q

According to Liu and Haan (2009), the typical prescribed doses of chlorpromazine to treat schizophrenia have increased/declined over the last 50 years

A

declined

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19
Q

As well as having antipsychotic properties, chlorpromazine is also an effective what?

A

Sedative

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20
Q

Which effect are typical antipsychotics such as chlorpromazine often associated with?

A

A sedative effect

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21
Q

The sedative effect of chlorpromazine is believed to be related to what?

A

Its effect on histamine receptors

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22
Q

True/False: It isn’t fully understood how chlorpromazine leads to sedation

A

True

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23
Q

True/False: Chlorpromazine is often used to calm individuals not only with schizophrenia but also with other conditions

A

True

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24
Q

Why is chlorpromazine often used to calm individuals not only with schizophrenia but also with other conditions?

A

Its sedative effect

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25
Q

Chlorpromazine has often been used to calm individuals not only with schizophrenia but also with other conditions, for example when patients are first admitted to hospitals and are…

A

very anxious

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26
Q

When is chlorpromazine usually given in a syrup form?

A

When being used for its sedative properties

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27
Q

Why is chlorpromazine often given in a syrup form when being used for its sedative properties?

A

Syrup is absorbed faster than tablets

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28
Q

There is a strong association between the use of typical antipsychotics and what?

A

The dopamine hypothesis

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29
Q

Chlorpromazine works by acting as what in the dopamine system?

A

Antagonists

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30
Q

Antagonists

A

Chemicals which reduce the action of a neurotransmitter

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31
Q

How do dopamine antagonists work?

A

By blocking dopamine receptors in the synapses of the brain, reducing the action of dopamine

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32
Q

Initially when an individual begins taking chlorpromazine are dopamine levels built up or broken down?

A

Built up

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33
Q

When an individual begins taking chlorpromazine, dopamine levels build up. After this, what happens to its production?

A

It is reduced

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34
Q

According to the dopamine hypothesis, the dopamine-antagonist effect does what?

A

Normalises neurotransmission in key areas of the brain

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35
Q

According to the dopamine hypothesis, the dopamine-antagonist effect normalises neurotransmission in key areas of the brain which reduces what?

A

Symptoms like hallucinations

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36
Q

Atypical antipsychotics are first/second-generation drugs

A

second

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37
Q

How long have atypical antipsychotics been used for?

A

Since the 1970s

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38
Q

What was the aim in developing newer antipsychotics?

A

To maintain and improve upon the effectiveness of drugs

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39
Q

The aim in developing newer antipsychotics was to improve upon the effectiveness of drugs in doing what?

A

Supressing the symptoms of psychosis and minimising the side effects of the drugs used

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40
Q

True/False: Atypical antipsychotics all work in the same way

A

False, not all do and we don’t know how some of them work

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41
Q

True/False: We know how atypical antipsychotics work

A

False, we don’t know how some of them work

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42
Q

Atypical antipsychotics were developed in the 19__s

A

1960s

43
Q

When were atypical antipsychotics first trialled?

A

The 1970s

44
Q

Why were atypical antipsychotics withdrawn for a while in the 1970s?

A

Following the deaths of some patients from a blood condition called agranulocytosis

45
Q

Typical/atypical antipsychotics were withdrawn for a while in the 1970s following the deaths of some patients from a blood condition called agranulocytosis

A

Atypical

46
Q

In the 1980s which type of antipsychotics were discovered to be more effective than the other?

A

Atypical

47
Q

In the 1980s what were atypical antipsychotics remarketed as?

A

Treatment for schizophrenia to be used when other treatments failed

48
Q

Clozapine is a(n) typical/atypical antipsychotic

A

atypical

49
Q

To this day, clozapine is still only used when…

A

other treatments fail

50
Q

Why do people taking clozapine have regular blood tests?

A

To ensure they are not developing agranulocytosis

51
Q

Why is clozapine not available as an injection?

A

Because of its potentially fatal side effects

52
Q

Daily dosage for clozapine is a little higher/lower than chlorpromazine

A

Lower

53
Q

What is the typical daily dosage of clozapine for someone with schizophrenia?

A

Typically 300 to 450mg a day

54
Q

True/False: Clozapine binds to dopamine receptors in the same way that chlorpromazine does

A

True

55
Q

Which receptors does clozapine act on in addition to the ones that chlorpromazine acts on?

A

Serotonin and glutamate receptors

56
Q

It is believed that what action helps clozapine improve mood and reduce depression and anxiety patterns?

A

It acting on serotonin and glutamate receptors

57
Q

The fact that clozapine is believed to help improve mood and reduce depression and anxiety patterns means it may improve what?

A

Cognitive functioning

58
Q

The mood-enhancing effects of clozapine mean that it is sometimes prescribed when an individual is considered at high risk of what?

A

Suicide

59
Q

Why is it important that the mood-enhancing effects of clozapine mean it is sometimes prescribed when an individual is considered at high risk of suicide?

A

30 to 50% of people with schizophrenia attempt suicide at some point

60
Q

__-__% of people with schizophrenia attempt suicide at some point

A

30-50%

61
Q

Which atypical antipsychotic has been around since the 1990s?

A

Risperidone

62
Q

Risperidone is a(n) typical/atypical antipsychotic

A

atypical

63
Q

Risperidone was developed in an attempt to produce what?

A

A drug as effective as clozapine but without its serious side effects

64
Q

In which forms can risperidone be taken?

A

Tablets, syrup or an injection that lasts for around two weeks

65
Q

Risperidone is usually given in a small/large initial dose

A

small

66
Q

Risperidone is usually given in a small initial dose and this is built up to a typical daily dose of_-_mg, and a maximum of __mg

A

4-8, 12

67
Q

Like clozapine, risperidone is believed to bind to which receptors?

A

Dopamine and serotonin recrptors

68
Q

Which atypical antipsychotic binds more strongly with dopamine receptors?

A

Risperidone

69
Q

Why is risperidone much more effective in much smaller doses than most antipsychotics?

A

It binds more strongly to dopamine receptors than clozapine

70
Q

Evidence suggests that the fact that risperidone is much more effective in smaller doses due to its stronger binds to dopamine receptors suggests this leads to…

A

Fewer side effects than other antipsychotics

71
Q

True/False: There is a large body of evidence to support the idea that both typical and atypical antipsychotics are moderately effective in tackling symptoms of schizophrenia

A

True

72
Q

Thornley et al. (2003) reviewed studies comparing the effects of what?

A

Chlorpromazine to control conditions

73
Q

Thornley et al. (2003)’s review included data from how many trials and how many participants?

A

13 trials, 1121 participants

74
Q

What did Thornley et al. (2003)’s review show about chlorpromazine?

A

Associated with better overall functioning - reduced symptom severity compared to placebo

75
Q

How did Thornley et al. (2003)’s ‘s review show chlorpromazine is associated with better overall functioning?

A

Reduced symptom severity compared to placebo

76
Q

Meltzer (2012) concluded that clozapine is…

A

more effective than typical antipsychotics and other atypical antipsychotics

77
Q

Meltzer (2012) concluded that clozapine is effective in __-__% of treatment-resistant cases where antipsychotics have failed

A

30-50

78
Q

What do Meltzer (2012)’s findings mean about the effectiveness of antipsychotics?

A

As far as we can tell, antipsychotics work

79
Q

What did Healy (2012) suggest about the evidence for effectiveness of antipsychotics?

A

There are serious flaws

80
Q

Healy (2012) said that most studies of the effectiveness of antipsychotics are of what?

A

Short-term effects only

81
Q

Healy (2012) found that some successful trials of antipsychotics have had their data published multiple times. What effect does this have?

A

Exaggerates the size of the evidence base for positive effects

82
Q

Healy (2012) said that because antipsychotics have powerful calming effects, it is easy to demonstrate that they have…

A

some positive effect on people experiencing the symptoms of schizophrenia

83
Q

Healy (2012) said that because antipsychotics have powerful calming effects, it is easy to demonstrate that they have some positive effect on people experiencing the symptoms of schizophrenia. This is not the same as…

A

saying they really reduce the severity of psychosis

84
Q

The flaws Healy (2012) found in evidence supporting the effectiveness of antipsychotics in treating schizophrenia mean what?

A

The evidence base for antipsychotic effectiveness is less impressive than it first appears

85
Q

The limitation of antipsychotic drugs is the likelihood of what?

A

Side effects

86
Q

Give 2 examples of side effects typical antipsychotics are associated with

A

Any 2 from dizziness, agitation, sleepiness, stiff jaw, weight gain, itchy skin, NMS and tardive dyskinesia (grimacing, blinking, lip-smacking)

87
Q

What is tardive dyskinesia caused by?

A

Dopamine supersensitivity

88
Q

What does tardive dyskinesia cause?

A

Involuntary facial movements such as grimacing, blinking and lip-smacking

89
Q

NMS is a serious side effect of antipsychotics, particularly typical/atypical antipsychotics

A

typical

90
Q

NMS is believed to be caused when what happens?

A

The drug blocks dopamine action in the hypothalamus

91
Q

The hypothalamus is an area in the brain associated with the regulation of a number of…

A

body systems

92
Q

What does NMS result in?

A

High temperature, delirium and coma, and can be fatal

93
Q

Estimates of the frequency of NMS as a result of antipsychotics range from less than .% to just over _%

A

0.1, 2%

94
Q

True/False: Antipsychotics can do harm as well as good

A

True

95
Q

Why may some people with schizophrenia avoid antipsychotics?

A

They can do harm as well as good - some people may experience severe side effects and therefore avoid such treatments

96
Q

We don’t know how some antipsychotics work - which ones?

A

Typical and at least some atypical

97
Q

Our understanding of the mechanism by which antipsychotic drugs work is strongly tied up with what?

A

The original dopamine hypothesis

98
Q

The original dopamine hypothesis includes the idea that symptoms of schizophrenia are linked to high levels of what, where?

A

Dopamine activity in the subcortex of the brain

99
Q

True/False: We now know that the original dopamine hypothesis is not a complete explanation for schizophrenia

A

True

100
Q

The original dopamine hypothesis suggests that dopamine levels in other parts of the brain are too low/high rather than too low/high

A

low rather than too high

101
Q

If the original dopamine hypothesis’ suggestion that dopamine levels in other parts of the brain are too low is true, what shouldn’t work?

A

Most antipsychotics

102
Q

Given that there are questions over the effectiveness of antipsychotics anyway, the fact that our understanding is strongly based on the original dopamine hypothesis adds to…

A

the argument that they are ineffective

103
Q

The argument that antipsychotics may be ineffective means that at least some antipsychotics may not be the best what?

A

Treatment to opt for

104
Q

The fact that our understanding of the mechanism by which antipsychotic drugs work is strongly tied up with the original dopamine hypothesis yet we now know that this isn’t a complete explanation for schizophrenia means that perhaps some other factor is involved in…

A

their apparent success

Psychology - IN FOCUS Schizophrenia (7 decks)

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