drug therapies Flashcards
what was the first drug used to treat schizophrenia?
chlorpromazine
do antipsychotics cure schizophrenia?
no, they just lessen the symptoms
what is the difference between typical antipsychotics and atypical antipsychotics?
typical (first-generation) were the original neuroleptic drugs created in the 50’s
atypical (second-generation) were a class of neuroleptic drugs produced later
how do typical antipsychotics work?
they arrest dopamine production through blocking the receptors in synapses that absorb dopamine, reducing positive symptoms
its now thought they also affect other neurotransmitter systems eg alpha-adrenergic and serotonergic
what are the possible side effects of typical antipsychotics?
dry mouth, urinary problems, constipation, low blood pressure, problems with sexual functioning, nasal congestion
how do atypical antipsychotics work?
act on serotonin and dopamine systems, affecting negative symptoms, but it’s not known how they do so
what is tardive dyskinesia?
-a side effect of typical drugs in 15% of people
-causes uncontrollable muscle movements, especially around the mouth
-can become permanent
what are the possible side effects of atypical antipsychotics?
weight gain, neuroleptic malignant syndrome (life-threatening neurological disorder w/ high fever, sweating, stupor and muscle rigidity), increased risk of stroke, sudden cardiac death, blood clots, diabetes and muscle tremors
what is the time frame for treating schizophrenia with drugs?
-hallucinations and agitation tend to reduce within a few days
-delusions within a few weeks
-after 6 weeks there’s much improvement
-!!!wide individual differences though!!!
-patients often have to take many different types before they find a suitable one
-some don’t respond at all
-can be combo therapy with psychological
what was the research conducted by bagnall et al 2003?
-data compiled from 171 randomly controlled trials + 52 non-randomised on effectiveness of drug treatments
-data compiled from 31 economic evaluations of antipsychotics
-analysed by 2 researchers to establish inter-rater reliability
-atypical drugs more effective, though there are differences in individual drugs
-no one drug is considered superior in symptom reduction, cost effectiveness and side effects
-all antipsychotics have criticisms, different drugs suit different patients
-most trials didn’t assess effectiveness of atypical on negative symptoms
-sertindole was removed in 1999 due to its association with sudden cardiac death
-poor quality research based on short-term trials, difficult to generalise
research on drug therapy
-davis et al 1989 - meta-analysis of 100+ studies comparing antipsychotics to placebos, finding drugs more effective, with over 70% of p’s improving after 6 weeks (less than 25% with placebos)
-khan et al 2008 - compared effectiveness of atypical vs typical in first-onset, finding both to be effective for the first year, but one wasn’t superior
evaluate the use of drug therapies
-antipsychotics are effective and relatively cheap to make, easy to administer
-high relapse rate, 40% in the first year after treatment, 15% in later years (usually from stopping treatment bcs side effects)
-atypical introduced to reduce typical side effects, which they did, but they have their own (arguable worse too)
-widespread use could be fuelled by money-hungry companies
