drug therapy Flashcards
drug therapy
involves use of antipsychotic drugs - some people with SZ can take short course of antipsychotics them stop use without return of symptoms, others may require them for life
typical APs - traditional
atypical APs - newer
typical APs
chlorpromazine - dopamine antagonists which block dopamine receptors in synapses of brain to reduce action of dopamine. dopamine production is reduced.
according to dopamine hypothesis of SZ, dopamine-antagonist effect normalises neurotransmission in key areas of brain - reduces hallucinations
atypical APs
clozapine - binds to dopamine receptions and acts on serotonin and glutamate receptors - helps improve mood and reduce depression and anxiety and may improve cognitive functioning
risperidone - binds to dopamine and serotonin receptors, binds more strongly to dopamine receptors than clozapine - effective in smaller doses
evaluation - evidence for effectiveness
thornley et al - reviewed studies comparing effects of chlorpromazine to placebo - data from 13 trials with 1121 PPs showed chlopromazine was associated with better overall functioning and reduced symptom severity. data also showed relapse rate was lower when chlorpromazine was taken
evaluation - serious side effects
typical APs associated with range of side effects - dizziness, sleepiness, weight gain. long term use can result in tardive dyskinesia - caused by dopamine supersensitivity and manifests as involuntary facial movements
atypical APs developed to reduce frequency of side effects but side effects still exist and people taking clozapine need regular blood tests to alert doctor to early signs of agranulocytosis
side effects still significant weakness of APs
evaluation - chemical cosh argument
widely believed that APs are used in hospital situations to calm people and make them easier for staff to work with, rather than for benefits to patients themselves
although short term use of APs to calm agitated patients is recommended by NICE, this may be seen as a human rights abuse by some
