biological therapy for schizophrenia

Question 1

what is the most common biological treatment for schizophrenia?

Answer 1

drug therapy

Question 2

what are the drugs most commonly used to treat scz?

Answer 2

antipsychotics

Question 3

what are antipsychotics?

Answer 3

drugs used to reduce the intensity of symptoms, in particular the positive symptoms, of psychotic disorders like schizophrenia

Question 4

what are typical antipsychotics?

Answer 4

the first generation of drugs for schizophrenia and other psychotic disorders, having been used since the 1950s. they work as dopamine antagonists and include chlorpromazine

Question 5

what is the main typical antipsychotic?

Answer 5

Chlorpromazine

Question 6

what relationship does chlorpromazine have with dopamine?

Answer 6

it’s a dopamine antagonist

Question 7

what is the usual dose for chlorpromazine?

Answer 7

800-1000mg

Question 8

what are dopamine antagonists?

Answer 8

they work by blocking dopamine receptors in the synapses of the brain, reducing the action of dopamine

Question 9

what does chlorpromazine do?

Answer 9

•sits on the post synaptic receptor sites
•the action potential is reduced, reducing the chance of the neuron firing
•reduces the effect of dopamine, reducing the chance of positive symptoms like hallucinations

Question 10

how long does it usually take to see side effects from antipsychotics?

Answer 10

a month

Question 11

limitation of typical antipsychotics: serious side effects!

Answer 11

•can lead to tardive dyskinesia- involuntary facial movements like grimacing, blinking and lip smacking
•dizziness, agitation, sleepiness, stiff jaw, weight gain, itchy skin
•could cause deaths
•treatments can cause harm

Question 12

what are atypical antipsychotics?

Answer 12

drugs for schizophrenia developed after typical antipsychotics. they typically target a range of neurotransmitters such as serotonin and dopamine.

Question 13

two examples of atypical antipsychotics

Answer 13

clozapine and risperidone

Question 14

what is clozapine’s relationship with dopamine?

Answer 14

it is still a dopamine antagonist

Question 15

how does clozapine work?

Answer 15

•a dopamine antagonist
•clozapine works in a similar way to chlorpromazine yet only binds to the D2 receptor site, reducing the chance of the patient developing tardive dyskinesia
•it unbinds from the receptor after about 3 days and binds to another D2 receptor site, allowing the receptor to still be stimulated

Question 16

what is the dose for clozapine?

Answer 16

350-450mg

Question 17

what is a side effect of clozapine?

Answer 17

it can cause a blood disease which has led to some deaths

Question 18

what is Risperidone?

Answer 18

•given in small doses (3-4mg) , can be a pill or injection
•effective in only a few days
•can treat depressive symptoms (which have a comorbidity of 50%)

-it is more expensive then less effective drugs

Question 19

evaluation points

Answer 19

+effective
-side effects
-issues of compliance

Question 20

strength: effective

Answer 20

•drug trials- Thornley
•did a meta- analysis of 13 trials which showed that chlorpromazine was associated with better overall functioning and reduced symptom severity compared to a placebo
•meltzer concluded that clozapine is more effective than typical antipsychotics and other atypical antipsychotics, and that it is effective in 30-50% of treatment-resistant cases where typical antipsychotics have failed
•this means that, as far as we can tell, antipsychotics work

Question 21

limitation: side effects

Answer 21

•dizziness, agitation, sleepiness, stiff jaw, weight gain, itchy skin
•tardive dyskinesia, involuntary movements such as grimacing, blinking and lip-smacking
•blood disease (possible death)
•heart arythmia
•seizures or fits, sexual dysfunction (erectile, loss of labido)

Question 22

limitation: issues of compliance

Answer 22

•people would refuse to take the drug due to side effects or the fact that they have paranoid delusions and believe they’re trying to be poisoned
•or they might forget/ not have the capacity to take the drug every day
-> revolving door syndrome, regular relapses
•depot injection, injected into fat above the hip and slowly dissolves over a month.
•these are unethical as you can’t withdraw consent, the patient can’t remove the drug from their body