BIOLOGICAL TREATMENTS FOR SCHIZOPHRENIA Flashcards
Name 3 biological treatments for schizophrenia?
- Typical anti-psychotics.
- Atypical anti-psychotics.
- Electro-Convulsive Therapy (ECT)
What are typical anti-psychotics?
First-generation anti-psychotics that primarily block dopamine receptors to treat positive symptoms of schizophrenia, but often cause movement-related side effects.
Name 2 types of typical anti-psychotics?
- Haloperidol
- Chlorpromazine
How do typical anti-psychotics work?
- Work by blocking dopamine activity. They bind to dopamine receptors (such as D2 receptors), preventing dopamine from activating them. This reduces positive symptoms like hallucinations and delusions.
Name 3 side effects of typical anti-psychotics?
- Extrapyramidal symptoms – e.g., tremors, muscle rigidity, restlessness (similar to Parkinson’s symptoms)
- Tardive dyskinesia – involuntary facial movements (can be long-term and irreversible)
- Sedation – drowsiness or lethargy
SET- SEDATION, EXTRAPYRAMIDAL, TARDIVE DYSKINESIA
What are a typical anti-psychotics?
Second-generation anti-psychotics, that block dopamine and serotonin receptors, targeting both positive and negative symptoms of schizophrenia, with a lower risk of movement side effects.
How do atypical anti-psychotics work?
- They block dopamine receptors (mainly D2) and serotonin receptors (mainly 5-HT2A).
- However, they rapidly dissociate (block dopamine for a short time). This rapid dissociation allows for normal dopamine/serotonin transmission to take place, which leads to less side effects.
Name 2 side effects of atypical anti-psychotics?
Less severe symptoms
* Weight gain
* Dowsiness
* Increased risk of diabetes – due to changes in blood sugar regulation
WID- Weight gain, increased diabetes risk, drowsiness
What researchers investigated the effectiveness of atypical/typical?
Sarkar and Grover (2013)
What was the aim of Sakar and Grover (2013) study?
- To conduct a meta-analysis on 15 randomised controlled studies/ drug trials which tested the effectiveness of anti-psychotics, on children and adolescents with schizophrenia.
What methods did Sarkar and Grover (2013) use?
- Meta-analysis on 15 drug trials
- Randomised controlled design
What were the results of Sarkar and Grover (2013)?
- 1st generation- Typical anti-psychotics: Extrapyramidal side effects were seem more in 1st generation drugs.
- 2nd generation- Atypical anti-psychotics: 2nd generation drugs were superior overall with clozapine being the most effective of all drug. More likley to have side effects affecting metabolism.
- Both 1st and 2nd generation anti-psychotic drugs were superior to placebo in alleviating symptoms.
Name 1 strength and 1 weakness of Sarkar and Grover (2013)?
- Real world application- Demonstrates which medication is most effective in treating schizophrenia and what side effects they have. this can be used to further educate patients on their treatment options, helping them make more informed decisions and improving medication compliance in real-world clinical settings.
- Weakness: low reliability and validity- As a meta-analysis, it may include studies with varying methods and quality, which could bias the findings or oversimplify differences in treatment effectiveness and side effects.
What is ECT?
A medical treatment in which small electrical currents are passed through the brain, for no longer than a second to induce a brief seizure. It is primarily used to treat severe MH conditions such as treatment resistant depression or bipolar and schizophrenia.
How does ECT work?
1) The procedure is completed under general anesthetics and muscle relaxants to minimise harm/pain.
2) Electrodes are placed on the scalp and small electrical currents are passed through the brain, for no longer than a second to induce a brief seizure.
3) The seizure lasts around a minute with the patient regaining consciousness around 15 minutes.
4) Electricity is applied unilaterally (left to right) to the non-dominate hemisphere to reduce memory loss.
How long does ECT treatment last?
- 6-12 sessions
- Spread across 2 days a week (to prevent symptom relapse)
How does ECT generally relieve schizophrenic, depressive and bipolar symptoms?
- The seizure activity is thought to trigger changes in brain chemistry, particularly affecting neurotransmitters like serotonin, dopamine, and norepinephrine.
- Schizophrenia- affects dopaminergic pathways
- Bipolar- Regulates neurotransmitter levels
- Depression- Resets dysregulated mood circuits.
Name 1 strength and 1 weakness of ECT?
- Rapid symptom relief: provides faster improvement in severe symptoms, suicidal tendencies, acute psychosis, catatonia compared to other treatments
- Ethical concerns: Carries ethical concerns which may reduce the liklihood of patients opting/adhereing to the treatment. For instance, it carries strong social stigma, can cause memory loss (especially retrograde amnesia) and cognitive impairments, which may reduce quality of life.
Name 1 strength and 1 weakness of anti-psychotics?
- Strength: research-backed (proven efficacy) Sarkar and Grover (2013).
- Weakness: Can cause major side effects which can result in non-adherence issues,
how can ECT relieve schizophregenic symptomns?
- Affects dopaminergic pathways- activating the dopamine system (at various levels), also increases release of neurotransmitters such as serotinin, dopamine and norephinpherine** (help with negative symptoms)
Name 2 types of atypical antipsychotics?
- Olanzapine
- Asenapine
