Drug Therapy Flashcards
What are antipsychotics?
Most common treatment
Depending on severity - short course or life time
2 types of antipsychotics
Typical (1st gen) used more often, if symptoms don’t improve atypical used
Atypical (2nd gen)
Explain typical antipsychotic? CHLORPROMAZINE
1st gen
Dopamine antagonists
Reduce levels of dopamine
Binds to D2 receptors on post synaptic neuron in brain reduces action of dopamine
Reduction in positive symptoms - hallucinations
Used as a sedative and calm paitients
What are Atypical antipsychotics? CLOZAPINE
2nd gen
Act upon neurotransmitters dopamine and serotonin
Binds to D2 receptor sites on post synaptic neuron
Reduces positive symptoms - hallucinations
Agonists open receptor sites increase levels of serotonin
Action reduces negative symptoms of SZ - lack of emotions, helps improve mood,
What are typical antipsychotic side effects?
Parkinsonism, affects patients motor movements and can be quite distressing to a prev fit individual
What are Atypical antipsychotics associated with?
Life threatening illness - agranulocytosis
What is agranulocytosis and how’s it monitored?
Agranulocytosis is a blood condition where there are low levels of white blood cells, preventing an individual fighting of diseases and illness
Monitored by having blood tests
A patient is only given a Atypical antipsychotics when?
When typical antipsychotics aren’t effective or if patients have sever negative side effects
Thornless - did a meta analysis what did he find?
What did meltzer find?
Evidence to support effectiveness
Rts effectiveness of typical and atypical antipsychotics
Thornley - meta analysis of 13 studies and 1121 pots investigating chlorpromazine against a placebo
Typical antipsychotic associated with better overall functioning and reduced symptom severity
Meltzer - clozapine more effective than typical antipsychotics effective 30 - 50% of treatment resistant cases
Therefore supporting antipsychotics are an effective treatment for positive and negative symptom of schizophrenia
what is the counter argument to THORNLEY?
- HEALY
suggests serious flaws with evidence for the effectiveness of antipsychotics
E.g most studies are of short term effects only and some successful trials were published several times with exaggerated results
as antipsychotics have a calming effect on behaviour it can be confused for a positive effect on symptoms of sz
placing doubt on research to support effectiveness of antipsychotics as a treatment of sz unsure whether results whether they reduce symptoms of SZ
why is antipsychotics requiring little motivation and commitment a strength of drug therapy?
typical and atypical antipsychotics require motivation and commitment from the patient
patient only has to take tablet in order to reduce symptoms of schizophrenia
UNLIKE CBT
requires motivation from patients have to attend sessions, engage in them, in order to identify and challenge irrational thoughts e.g
delusions,
as it may be difficult for a person with sz may not have an accurate perception of reality
its beneficial for those with neg symptoms e.g avolition who struggle with keeping up with everyday tasks as they receive immediate positive side effects on their symptoms
drug therapy may be more appropriate than CBT in treating sz cause its more acessible treatment across the symptoms
what is a weakness to drug therapy?
negative side effects
typical antipsychotics e.g chlorpromazine produces movement side effects e.g Parkinsonism, moreover typical carry the risk of life threatening illnesses, agranulocytosis.
UNLIKE CBT
involves a person identifying and challenging their irrational thoughts, without use of rugs, no neg effects and potentially life treating diseases
drug therapy may not be appropriate for all patients as side effects reduce effectiveness of drug therapy as a treatment of sz some people may stop taking them resulting in relapse of symptoms
