drug therapies Flashcards

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1
Q

what was the first drug used to treat schizophrenia?

A

chlorpromazine

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2
Q

do antipsychotics cure schizophrenia?

A

no, they just lessen the symptoms

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3
Q

what is the difference between typical antipsychotics and atypical antipsychotics?

A

typical (first-generation) were the original neuroleptic drugs created in the 50’s
atypical (second-generation) were a class of neuroleptic drugs produced later

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4
Q

how do typical antipsychotics work?

A

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

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5
Q

what are the possible side effects of typical antipsychotics?

A

dry mouth, urinary problems, constipation, low blood pressure, problems with sexual functioning, nasal congestion

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6
Q

how do atypical antipsychotics work?

A

act on serotonin and dopamine systems, affecting negative symptoms, but it’s not known how they do so

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7
Q

what is tardive dyskinesia?

A

-a side effect of typical drugs in 15% of people
-causes uncontrollable muscle movements, especially around the mouth
-can become permanent

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8
Q

what are the possible side effects of atypical antipsychotics?

A

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

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9
Q

what is the time frame for treating schizophrenia with drugs?

A

-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

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10
Q

what was the research conducted by bagnall et al 2003?

A

-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

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11
Q

research on drug therapy

A

-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

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12
Q

evaluate the use of drug therapies

A

-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

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