Biological therapy for schizophrenia

Question 1

Antipsychotics

Answer 1

Drugs used to reduce the intensity of (Positive) symptoms of SZ

Question 2

What are the two types of drugs used in drug therapy for SZ

Answer 2

1) Typical antipsychotics
2) Atypical antipsychotics

Question 3

Typical antipsychotics

Answer 3

• Taken as tablets, syrup or injection
• Max 1000 mg
• Dosage is gradually increased to a max of 400 - 800 mg
• Usage declined over last 50 years

Question 4

What is the main type of typical antipsychotics

Answer 4

Chlorpromazine

Question 5

Dopamine antagonist

Answer 5

• Work by acting as antagonists in dopamine system
• Reduce action of neurotransmitters
• Block dopamine receptors
• Reduce symptoms

Question 6

Sedation effect

Answer 6

• Effective sedative
• Effect on histamine receptors
• Calm individuals with SZ (admitted)
• Syrup is absorbed faster than tablets

Question 7

Atypical antipsychotics

Answer 7

• Improve on the effectiveness of drugs in suppressing symptoms
• Minimises side effects

Question 8

What is the main types of atypical antipsychotic

Answer 8

Clozapine and Risperidone

Question 9

Clozapine

Answer 9

• More effective than typical
• People who take these regularly also need regular blood tests o check they don’t get agranulocytosis (blood clots)
• Potentially fatal side effects
• Not available as injection
• Daily dosage = 300 - 450 mg
• Acts on serotonin and glutamate receptors as well as binding to dopamine receptors
• Improve mood and reduce depression

Question 10

Risperidone

Answer 10

• As effective as clozapine but with no serious side effects
• Tablets, injection or syrup
• Lasts for around 2 weeks
• Daily dosage = 4 - 8 mg to a max of 12 mg
• Bind to dopamine and serotonin receptors
• More effective in smaller dosages

Question 11

Biological therapy for SZ evaluation points- Evidence for effectiveness

Answer 11

STRENGTH

• Chlorpromazine more effective than placebo, with decrease symptom severity, over 1000 patients (Thornly)
• Clozapine more effective than typical antipsychotics, especially treatment-resistant case (Meltzer)

Question 12

Biological therapy for SZ evaluation points- Evidence for effectiveness counterpoint

Answer 12

LIMITATION

• Short term studies
• Some data sets with positive findings published more than once
• Sedative effect may explain postive results
• Healy

Question 13

Biological therapy for SZ evaluation points- Serious side effects

Answer 13

LIMITATION

• Mild = Stiff jaw and sleepiness
• Serious = Tardive dyskinesia
• Fatal = Neuroleptic malignant syndrome

Question 14

Biological therapy for SZ evaluation points- Mechanisms unclear

Answer 14

LIMITATION

Most antipsychotics based on the dopamine hypothesis which may be wrong