Biological therapy for schizophrenia

Question 1

-Antipsychotics
-Typical
-Atypical

Answer 1

-Drugs used to reduce intensity of symptoms in particular positive symptoms
-The first generation of drugs for schizophrenia -dopamine antagonists and chlorpromazine
-Drugs for schizophrenia developed after typical antipsychotics-target neurotransmitters such as dopamine and serotonin-Clozapine and risperidone

Question 2

Drug therapy

Answer 2

Antipsychotic drugs
Psychosis , hallucinations and delusions
Can be used short-term or long-term

Question 3

Typical antipsychotics-dopamine antagonists and sedation effect

Answer 3

Since 1950s-chlorpromazine-tablets, syrup, injections
Maximum of 100 MG but start off smaller and build up (400-800)
Perscription is declined over last 50 years

Question 4

Typical-dopamine antagonists

Answer 4

Typical associated with dopamine hypothesis-antagonist reduces the action of a neurotransmitter.
Block dopamine receptors which reduces dopamine action
Dopamine buildup is produced less
Normalises neurotransmission in the brain and reduces hallucinations

Question 5

Typical-sedation effect

Answer 5

Chlorpromazine is sedative because of its effect on histamine receptors.
Used to calm people down with other conditions
Syrup absorbs faster so given orally to sedate

Question 6

Atypical antipsychotic-Clozapine and risperidone

Answer 6

Used since the 70s-developed to maintain or improve effectiveness of suppressing
Temporary binding to reduce side effects
Also act on serotonin and glutamate receptors which affect mood and anxiety

Question 7

Atypical-clozapine

Answer 7

Developed in 1960s-trial in 1970s.
Withdrawn due to death linked to blood conditions -introduced when proven more effective than typical-when all of the treatment fails. Have to take regular blood tests. Can’t inject
Daily dosage 300 to 400 MG

Question 8

Atypical-risperidone

Answer 8

1990s-As effective as chlorpromazine without side-effects. Tablets, syrup or injection
Last around two weeks . Initially small dose. Buildup to 4 to 8 MG
Bind dopamine and serotonin receptors
More effective in smaller doses

Question 9

Atypical-risperidone

Answer 9

1990s-As effective as chlorpromazine without side-effects.

Question 10

Strength-evidence for effectiveness

Answer 10

Are both at least moderately effective
Thornley -effective chlorpromazine vs control condition. Better overall functioning reduced symptoms
Meltzer-clorapine More effective than typical and other atypical. 30 to 50% effective of previous failed treatments

Question 11

Limitations-Counterpoint

Answer 11

Healy-flawed evidence-exaggerated claims
Most are only short term effects
have a calming effect so it’s easy to say they have a positive effect .
Not the same as saying the severity is reduced .

Question 12

Limitation-side effects

Answer 12

Typical-Dizziness, stiff jaw, itchy skin, agitation, sleepiness, weight gain
Most serious side effects : delirium, high temperature, coma

Question 13

Limitation-unclear mechanism

Answer 13

We don’t know why they work
Originally think of the dopamine hypothesis however we know this is not a complete explanation for schizophrenia
Dopamine levels in some parts of the brain are too low so most antipsychotics shouldn’t work
Other Factors may be involved in their success

Question 14

Limitation

Answer 14

Hospitals use antipsychotics to calm patients down to make them easier to work with rather than for their own benefit.
However this does make them feel calmer so they can engage better in treatment