drug therapy Flashcards
typical antipsychotic years
e.g. chlorpromazine
first generation drugs (1950s)
atypical antipsychotic years
e.g. clozapine and risperidone
second generation drugs (1970s, 1990s)
typical antipsychotics
chlorpromazine
work off the principles of the original dopamine hypothesis
therefore, chlorpromazine works by acting as a dopamine antagonist
this means typical anti-psychotics bind to d2 receptors to prevent too much dopamine from being absorbed by the d2 receptors
this normalises neurotransmission in key areas of the brain, reducing positive symptoms of schizophrenia, such as hallucinations
atypical antipsychotic 1
clozapine - developed in the 1960s and first trialled in the 1970s
withdrawn for a while in 1970s following the deaths of some patients from a blood condition - agranulocytosis
however, it was remarketed as a treatment for schizophrenia to be used when other treatments failed as it was found to be more effective than typical antipsychotics
clozapine is suggested to be more effective than typical antipsychotics as it binds to dopamine receptors like chlorpromazine; but also acts on serotonin and glutamate receptors
as clozapine targets neurotransmitters other than dopamine, it treats positive and negative symptoms of schizophrenia
by acting on serotonin and glutamate receptors, clozapine reduces depression and anxiety in patients, which up to 50% of schizophrenics suffer from
dopamine antagonist
drug that binds to the dopamine receptor to block its action and reduce levels of dopamine reaching the postsynaptic neuron
agranulocytosis
severe decrease in white blood cells, which can lead to infection (septicaemia) and death
atypical antipsychotic - risperidone
developed in 1990s as clozapine was involved in deaths of some patients from a blood condition - agranulocytosis
risperidone binds to dopamine and serotonin receptors
however, risperidone binds more strongly to dopamine receptors and is therefore more effective in smaller and has fewer side effects, compared to other antipsychotics
supporting research for typical anti-psychotics
supporting research evidence to suggest they are effective
thornley et al 2003
reviewed data from 13 trials (1121 ppts) and found that chlorpromazine was associated with better functioning and reduced symptom severity compared to a placebo
this strengthens the biological treatments of schizophrenia as typical anti-psychotics help schizophrenic patients in minimising their symptoms to enhance their quality of life
supporting research for atypical anti-psychotics
additional supporting research to suggest atypical anti-psychotics are also effective
meltzer et al 2012
concluded that clozapine is more effective in 30-50% of treatment resistant cases where typical anti-psychotics have failed
this suggests that atypical anti-psychotics are more effective than typical anti-psychotics in the treatment of schizophrenia, meaning clozapine may be a better drug treatment for schizophrenia compared to chlorpromazine
limitation of drug treatments
other treatments may be more clinically successful
this is because anti-psychotics only reduce schizophrenic symptoms, rather than tackling the underlying cause
for example, if a patient stops taking their medication, their schizophrenia symptoms may reappear resulting in the patient becoming reliant on the drugs to function normally
this suggests psychological therapies, such as CBT, which tackle the underlying causes of schizophrenia (e.g. dysfunctional thought processing) are more successful than drug therapies
psychology +
some would argue drug treatments of schizophrenia are still more effective than psychological treatments as they are more cost effective
e.g. they do not require a trained psychologist
ensure patients can return to work quicker, and minimise the burden on the NHS
