Biological Treatments - drug therapy Flashcards
Difference between typical and atypical antipsychotics
Typical - target just dopamine
Atypical - target dopamine and other neurotransmitters like serotonin and glutamate
what are the 3 different drugs that are used to treat SZ
Chlororomazine (1950)
Clozapine (1970)
Risoeridone (1990)
How do the 3 drugs work?
Chlorpromazine - blocks D2 receptors by binding to them and reduces dopamine
Clozapine - blocks dopamine, serotonin and glutamate receptors
Risoeridone - blocks dopamine and serotonin receptors
What symptoms do the 3 drugs help with?
Chlorpromazine - positive symptoms eg hallucinations
Clozapine - positive symptoms eg avolition from serotonin
Risoeridone - both positive and negative symptoms
Effectiveness of the 3 different drugs
Chlorpromazine- 70% effective in treating positive symptoms - 1121 had increased functioning
Clozapine - 30-50% effectiveness in treatment resistant cases
Risoeridone - 81% effectiveness particularly with negative symptoms
Risk of relapse with all 3 drugs
Chlorpromazine- after 2 years 55% relapsed
Clozapine - 2/23 - low rate
Risoeridone- 41% relapsed- seems to depend on the person
Side effects of the 3 drugs
Chlorpromazine- Tardive Dyskinesia, Neuroleptic Malignant (coma and death) syndrome
Clozapine - Agranulocytosis but can be controlled with regular blood tests
Risoeridone - unusual gait, seizures
Cost of each of the 3 drugs
Chlorpromazine- £40.33 for 3 tablets
Clozapine - £12.07 for 3 tablets
Risoeridone- £1.19 for 30 tablets
How quickly do each of the drugs start to work
Chlorpromazine- few days though it does take time for effects to build up in the system
Clozapine - 3-6 weeks
Risoeridone- days to months
EVALUATION of drug treatments of SZ
STRENGTH - research support for the effectiveness of using antipsychotics - typical antipsychotics like chlorpromazine has 70% effectiveness suggesting that D2 receptors being blocked is effective in removing positive symptoms - atypical like risperidone has 81% effectiveness so should be used to treat SZ as it improves QOL as it can be taken with the community - however there are ethical considerations as they are open to abuse eg the COSH argument says that chlorpromazine has a sedative effect and may not be best for the patient but makes them easier to manage
moreover severe side effects - Chlorpromazine has Tardive Dyskinesia which causes parkinson’s like symptoms eg repetitive motor movements of the mouth and jaw which is permanent even after person stops taking drugs - atypical like clozapine have side effect of agranulocytosis (blood disorder that can lead to death). Questions whether antipsychotics are best for the patient and if they will benefit - questions whether they should be prescribed especially for more milder cases and whether CBp of family therapy would be a better option as they have no side effects
Furthermore antipsychotics do not necessarily treat the cause of schizophrenia it is more the symptoms which could lead to long term and high relapse - typical antipsychotics have a 55% relapse rate and atypical antipsychotics are not much better as risoeridone has a 41% relapse rate suggesting tbh work when taken but not when stopped - research shows an interactionist approach of CBp, family therapy and medication leads to a 0% relapse rate
