biological treatment for schizophrenia Flashcards
typical antipsychotic drugs - P1, A01
Typical antipsychotic drugs are well established.
They are dopamine antagonists which means that they reduce the positive symptoms of schizophrenia, such as delusions or hallucinations, by blocking the postsynaptic dopamine receptors without activating them.
The most effective typical antipsychotic drugs bind to D2 receptors, which is the main receptors which are implicated in schizophrenia.
Typical antipsychotic drugs are also found to cause side effects such as tardive dyskinesia which is when an individual experiences uncontrollable stiff or slow writhing movement of the face and body.
weakness of typical antipsychotic drugs - P1, A03
One weakness of using drug therapy to treat schizophrenia is that the drugs can cause serious side effects for some patients.
Typical antipsychotic drugs can be associated with disturbances of movement and posture such as tremors and muscle spasms.
They can also in the long term cause patients to have a condition called tardive dyskinesia which causes involuntary muscle spasms that commonly occur around the mouth and affect speech and are irreversible along with Parkinson’s like symptoms.
Therefore, this means that typical antipsychotic drugs can cause long term affects which are irreversible so may have life changing effects on these patients which are worse than the symptoms they are originally experiencing by having schizophrenia.
CHAIN OF REASONING weakness of typical antipsychotic drugs - P1, A03
Furthermore, there has been study evidence found that some people are likely to stop taking their antipsychotic drugs due to the vast amount of side effects which are experienced. Lieberman et al found in 2005 that patients were more likely to carry on taking atypical antipsychotic drugs than typical psychotic drugs due to the difference in severity of side effects.
This will make the typical antipsychotic drugs prescribed to patients ineffective because people are not taking them so cannot improve and reduce their schizophrenic symptoms. Therefore, this means that some typical antipsychotic drugs can be ineffective as people don’t take them properly due to the side effects which they cause people.
atypical antipsychotic drugs - P2, A01
Atypical antipsychotic drugs act on serotonin and glutamate receptors so they are antagonist antipsychotic drugs.
The atypical antipsychotic drugs are said to reduce both positive and negative symptoms of schizophrenia.
However, they cause side effects such as agranulocytosis, specifically the drug clozapine which was developed in the 1960s.
Agranulocytosis reduces a patients white blood count and increases the risk for infections.
Due to this, patients on clozapine must have blood tests every fortnight to monitor their blood count.
strength of atypical antipsychotic drugs - P2, A03
One strength of using atypical antipsychotic drugs to treat schizophrenia is that there is a large amount of empirical evidence from a large meta-analysis to show that symptoms and relapses are reduced.
Zhao et al in 2016 compared 18 antipsychotics using data from 56 randomised controlled trials using 10,000 patients.
They found that 17 of the antipsychotic drugs tested had significantly lower rates or relapsing than those who were administered the placebo treatment.
Therefore, this means that there is study evidence to show that patients who are given antipsychotic drugs can avoid relapse and experience reduced schizophrenic symptoms.
COUNTER ARGUMENT TO strength of atypical antipsychotic drugs - P2, A03
However, there is study evidence from Patel et al in 2014 that shows patients show little to no improvement following taking antipsychotic drugs.
They found that 20% of people with schizophrenia showed little improvement after being given multiple antipsychotic trials and 45% of people experience partial or inadequate improvement and unacceptable side effects.
Therefore this means that, there are a large amount of people with schizophrenia who are taking antipsychotic drugs which fail to function in everyday life because their symptoms are not being reduced enough to enable them to live their everyday lives.
antipsychotic drugs corecting imbalance of neurochemicals in brain - P3, A01
Antipsychotic drugs correct the imbalance of a certain neurochemical within the brain.
They can help to reduce or increase the level of dopamine in areas within the brain which are associated with schizophrenic symptoms depending on whether an individual has an excess or deficiency of dopamine.
Their primary mechanism within the brain is blocking the dopamine receptors in this area of the brain which prevents dopamine bringing to the receptors in the synapse which causes depolarisation of neurones so schizophrenic symptoms decrease.
weakness of antipsychotic drugs corecting imbalance of neurochemicals in brain - P3, A03
One weakness of using antipsychotic drugs to treat a patient with schizophrenia is that it can be unethical.
If a patient is detained under section 3 of the Mental health act, they can be given treatment without consent if it is deemed necessary.
Drug therapy is 1 of 3 treatments that can be given this way and it can be argued that it breaches ethical guidelines.
For treatment to be given without the patients consent, there current state of mind must be considered – this is if they are putting themselves or others in danger.
In some cases, it could be argued that the patients symptoms mean that they are unable to know what is best for them so receiving treatment without consent is the most positive course of action.
Therefore, this means that some patients may be given the antipsychotic drugs against their will as they are not given a decision.
This is unethical because they may not wish for this to happen but have no choice in the matter.
COUNTER ARGUMENT TO weakness of antipsychotic drugs corecting imbalance of neurochemicals in brain - P3, A03
However, one strength of the use of antipsychotic drugs is that it has enable people with schizophrenia to live life differently while being able to cope.
The advent of antipsychotics in the 1950s has led to an enormous change in the way in which people with schizophrenia could live their lives.
People with a diagnosis of schizophrenia had the chance to remain in the community while being able to cope and avoid institutionalisation.
This is important because if people with schizophrenia become segregated from the community it will increase the stigmatisation due to individuals with schizophrenia having little to no interaction with the rest of the community.
Therefore this means that individuals with schizophrenia are able to be a part of their local community and live their lives in a more normal way due to antipsychotic drugs being able to reduce their symptoms so they can cope in social situations.
how are antipsychotics administered - P4, A01
Antipsychotic drugs can be administered to patients in tablet form or can be given by a nurse or doctor through an injection. Generally, antipsychotic drugs take up to 2 weeks to start reducing peoples symptoms of schizophrenia.
If an individual has been experiencing schizophrenia treatments for many years, the drugs often fail to relieve their symptoms. The first five years of someone having schizophrenia following an acute episode of schizophrenia symptoms can lead to the most significant changes within ones brain.
strength of how are antipsychotics administered - P4, A01
One strength of using antipsychotic drugs is that there is study evidence to show that they are effective at treating the positive symptoms of schizophrenia.
Brar et al found that clozapine had shown to be highly effective in treating the positive symptoms of hallucinations and other associated psychotic symptoms including some negative symptoms such as emotional withdrawal, even in people who had not previously responded to treatment with other drugs. This means that there is study evidence to show that certain antipsychotic drugs are effective at treating the positive and some negative symptoms of schizophrenia.
COUNTER ARGUMENT TO strength of how are antipsychotics administered - P4, A01
However, a large amount of the research carried out is on animals.
Kapur et al pointed out that high doses of medication can be given to animals to block D2 receptors effectively but this dosage in humans produces severe side effects.
Animal models cannot show how these side effects would lead to lack of compliance in humans.
Therefore, this means that the lab research carried out on animals cannot always replicated the lived experiences of taking daily antipsychotic medication and coping with the side effects in humans.
