Biological Treatment of Schizo - Drug Therapy Flashcards
Name the TYPICAL or first generation antipsychotics
FGAs
Name the ATYPICAL or second generation antipsychotics
SGAs
What does FGA do
Dopamine antagonist
Reduces positive symptoms by blocking postsynaptic dopamine receptors without activating them
What receptors do they bind to
D2
What symptoms do FGAs reduce and findings of drugs
Positive
BUT
40% experience no relief
May still have negative symptoms
Experience side effects -> uncontrollable stiff or writhing movements of face and body
Study about FGAs and their findings
Barlow and Durand (1995)
Reduces positive symptoms
40% gain no relief
Many still experience negative symptoms
Drug examples of SGAs
Clozapine
Risperidone
What does clozapine do
Blocks dopamine (same way as FGAs)
Serotonin and glutamate antagonist
Symptoms of clozapine
Reduces positive and negative
side effects Of clozapine
Agranulocytosis - blood condition
60% of patients feel relief
Need regular blood tests
Clozapine study and results
Lally and MacCabe (2015)
Side effect agranulocytosis
Provides relief for 60%
What does risperidone do
Binds to serotonin and dopamine
Why is risperidone so good compared to other antipsychotics
Binds strongly to dopamine receptors than clozapine so effective in smaller doses than most antipsychotics
What is the doctors aim to do after the first week of a psychotic episode
Decrease hostility and return client to normal functioning (sleeping etc)
What do the doctors monitor
Changes in symptoms and side effects
What does the maintenance dose do
Encourages socialisation
Combats relapse
Continues for 12 months after remission
What are the relapse statistics found
18-32% relapse who TAKE meds
60-80% relapse who DON’T take meds
What can’t be taken in patients due to medication
Amphetamines, alcohol, caffeine, nicotine
Disrupt effectiveness of antipsychotic medications
What can be seen as a weakness of the drugs
Rail to bring relief to people who have experiences symptoms for a long period of time
5 years and acute episode leads to most significant brain changes
Strength of the medication study
Zhao et al (2016)
What did strength Zhao et al (2016) find
56 randomised trials with over 10,000 people
17/18 antipsychotic drugs has significantly lower relapse rates than placebo
Help avoid emotional and financial cost of hospital treatments
What is a weakness of Zhao et al (2016)
Patel et al (2014)
20% of ppl with schizo showed little improvement after multiple FGA trials, 45% experience partial or inadequate improvememt
Many ppl struggle with everyday life who take the meds
Weakness studies
Kapur et al (200)
Turner et al (2012)
What did Kapur et al (2000) find
Many studies involving drugs are animal studies
Medication blocks D2 receptors effectively but produce severe side effects with same doses
Animals cannot show how side effects affect everyday life or lack of compliance
Lab research cannot replicate experience of taking medication and coping with side effects
What did Turner et al (2012) find
Publication bias towards studies showing positive outcome of antipsychotic drugs
Drug effectiveness exaggerated, doctors make inappropriate treatment decisions
