Biological therapy for schizophrenia

Question 1

What is the most common treatment for schizophrenia

Answer 1

Antipsychotic drugs

Question 2

What is psychosis

Answer 2

Loss of contact with reality through hallucinations/delusions
-Defining characteristic of schizophrenia

Question 3

Are anti-psychotics short-term or long term?

Answer 3

Both as depends on the patient

Question 4

What are typical antipsychotics

Answer 4

Around since 50s e.g clorpromazine
-Dosages have declined over last 50 years

Question 5

How do typical antipsychotics like chlorpromazine work?

Answer 5

Act as dopamine antagonists and block dopamine receptors in synapses
=normalises neurotransmission in key areas of brain which - symptoms like hallucinations

Question 6

What are antagonists

Answer 6

Chemicals which reduce the action of a neurotransmitter

Question 7

How is chlorpromazine also used

Answer 7

As sedative for schizophrenics/anxious patients
-In this case given as syrup

Question 8

What are atypical antipsychotics

Answer 8

Newer (70s)
-Developed to be more effective in - psychosis with less side-effects
-Don’t all work the same and we don’t know how some work

Question 9

What is clozapine

Answer 9

Atypical antipsychotic used when other S treatments fail
-Must have regular blood tests as potentially fatal side effects (no injection)
-Daily dosage lower than chlorpromazine

Question 10

How does clozapine work

Answer 10

Binds to dopamine/serotonin/glutamate receptors= reduced anxiety/depression

So sometimes prescribed when suicidal

Question 11

What percentage of schizophrenics attempt suicide

Answer 11

40%

Question 11

What is Risperidone

Answer 11

Newer atypical antipsychotic (90s)
-Designed to be as effective as clozapine - the side-effects
-Maximum dosage of 12 mg

Question 12

How does risperidone work

Answer 12

Binds to serotonin/DA receptors
-Binds more strongly to DA= can be taken in much smaller doses/less side-effects than other anti-psychotics

Question 13

Strength of antipsychotics

Answer 13

Evidence for effectiveness
-e.g Thornley (2003) reviewed studies with chlorpromazine/placebo= c more effective
-Meltzer (2012) said clozapine most effective

So seem to work

Question 14

What percentage of treatment-resistant cases did clozapine work (Meltzer 2012)

Answer 14

40%

Question 15

Counterpoint to evidence of antipsychotic drugs effectiveness

Answer 15

Evidence-base flawed
-David Healy (2012): Most study only short-term effects
-Some trials had data published many times= exaggerates size of evidence
-May just calm ppl so not really reducing severity of psychosis

Question 16

Weakness of antipsychotics

Answer 16

Side effects:
Weight gain/dizziness/stiff jaw/sleepiness
-Long term use can= tardive dyskinesia
-Most serious= NMS (high temp/delirium/coma)

So ppl may be scared and not take them

Question 17

2 weakness of antipsychotics

Answer 17

Don’t know why they work
-Understanding from original DA hypothesis but this is not a complete explanation (e.g sometimes DA is too low)
-Mean most APs shouldn’t work

So some APs may not be best treatment/may be other factors in their success