Biological Treatment for Sz: Antipsychotics Flashcards
When were the first APs developed?
In the 1950s
What do APs attempt to do?
Attempt to balance the NTs in the brain
What are the first generation of APs classified as?
Classified as typical APs
What do typical APs aim to do?
Aim to block dopamine receptors in the brain
D2 receptors
What is an example of typical APs?
Chlorpromazine which are phenothiazines
What are typical APs described as being?
Described as being neuroleptics - acting at the neuron
Suppress positive symptoms
How long do typical APs need to be taken to get the full benefit?
6 months
What are the second generation of APs classified as?
Classified as atypical APs
Which symptoms are atypical APs better at treating?
Negative and cognitive
What are atypical APs mode of action like?
Works on other NTs such as glutamate and serotonin as well as dopamine
Which AP seems to be the most effective?
Clozapine
Found to reduce suicidal feelings
How long do patients need to take APs?
Depends on type of Sz
One psychotic episode - up to 2 years
Chronic Sz - lifetime medication
What is the supporting evidence/strengths of antipsychotics as a treatment for Sz?
Meltzer et al (2004)
Leucht et al (2018)
Ethical
Rapid effect
Holistic approach
What is the refuting evidence/weaknesses of antipsychotics as a treatment for Sz?
Rosa et al (2004)
Social control
Palliative
Reductionist
Side effects
Why is Meltzer et al (2004) supporting evidence of antipsychotics as a treatment for Sz?
Meltzer studied 481 patients who were divided into two groups: placebo or haloperidol (AP) for six weeks
He noted a significant reduction in symptoms for those taking AP compared to placebo
Supports effectiveness of APs - reduces symptoms
Why is Leucht et al (2018) supporting evidence of antipsychotics as a treatment for Sz?
Leucht conducted a meta-analysis consisting of over 6,000 patients with Sz
Compared rates of re-hospitalisation for those given APs (10%) with those given placebo (26%) suggesting medication was effective in reducing symptoms of Sz
Supports effectiveness of APs - reducing symptoms of Sz
Why is ethics a strength of antipsychotics as a treatment for Sz?
APs viewed as both cheaper and more ethical way of treating patients who may previously have been institutionalised or treated with electro-convulsive therapy
Drugs allowed patients to remain living in the community whilst assessing other therapies
Supports usefulness of APs
Why is rapid effect a strength of antipsychotics as a treatment for Sz?
Rapid effects compared to other types of therapy such as counselling because patients can be relieved of some symptoms in a matter of weeks
APs more easily accessible from NHS whereas psychological therapies may have extended waiting lists
Supports effectiveness - rapid effect in relieving symptoms
Why is holistic approach a strength of antipsychotics as a treatment for Sz?
Appears to take an ‘eclectic’ or more holistic approach by combining the medication and counselling such as CBT or family therapy (to address the possible stressful triggers which may be involved in onset of symptoms)
Why is Rosa et al (2004) refuting evidence of antipsychotics as a treatment for Sz?
Rosa found that only 50% of patients comply consistently with their medication regime for Sz which can often lead to relapses and re-admittance to hospital
Challenges effectiveness of APs as not all patients will remember to take them or will deliberately avoid taking them
Why is social control a weakness of antipsychotics as a treatment for Sz?
Some argue that APs are ‘chemical straight-jackets’ and believe that prescribing such medication is a form of social control whereby doctors can enforce compliance to the medication regime through sanctions
Challenges ethics behind APs
Why is palliative a weakness of antipsychotics as a treatment for Sz?
Some would argue APs are palliative and not curative meaning that they don’t address the causes of Sz, only masking the symptoms
Means the treatment isn’t fully effective
Challenges effectiveness of APs - underlying issues not addressed
Why is reductionist a weakness of antipsychotics as a treatment for Sz?
Use of APs as a treatment for Sz may be challenged for being too simplistic and reductionist
Simply adjusting levels of NTs doesn’t address other social factors which may play a role in the onset of Sz
Doesn’t address other issues that may cause Sz such as social factors - focuses on biological factors
Why is side effects a weakness of antipsychotics as a treatment for Sz?
APs often produce unpleasant side effects which themselves often require further drug treatment
Side effects of APs include weight gain, shaking, and tiredness. Such side effects may make the patient feel physically unwell
Raises issues with side effects of APs which may cause patient to avoid taking them
