drug therapy Flashcards
what does drug therapy involve
- the treatment of Sz through antipsychotic medication to reduce the symptoms of the disorder
- can be taken as tablets, syrup or injection
- can be taken for a short time or some may need it for life
- helps the person with Sz function as well as possible and increases feelings of subjective well-being
- all antipsychotics reduce dopaminergic transmission
what’re the 2 types of antipsychotics
Typical
Atypical
expand on Chlorpromazine’s dosage, type, time invented, and drug mechanics
- Typical
- 1950s
- tablet, liquid or injection
- gradually increased dosage, 400-800mg/day, max of 1000mg
- links to the dopamine hypothesis, blocking the dopamine receptors in the brain. initial rise in dopamine levels but eventual slow in dopamine production
what’re the effects of Chlorpromazine in treating Sz
- reduces positive symptoms of hallucinations/delusions from hyperdopaminergia
- side effect of a sedative, often used for calming anxious Sz patients when first admitted to hospital
expand on the Clozapine’s dosage, type, time invented, and mechanics
- Atypical
- 1970s
- only available as tablet as it can be fatal
- only used when other treatments fail, patient must take regular blood tests
- max of 450mg/day
- binds to dopamine receptors as typical antipsychotic drugs do
- effective sedative
what does clozapine do that chlorpromazine and typical antipsychotics don’t
- also works on serotonin and glutamate receptors, increasing serotonin levels on the brain, reducing anxiety/depression.
- works well in patients at risk of suicide/SH and have comorbidities with depression (50%)
what is the bad side effect of Clozapine
Agranulocytosis - low white blood cell count
what is the bad side effect of chlorpromazine
neuroleptic malignant syndrome (NMS), resulting in high temp, coma and can be fatal. occurs in 1% of patients
involuntary facial movements
expand on risperidone’s dosage, type, time invented, and mechanics
- Atypical
- 1990s
- tablet, liquid or injection
- works similarly to clozapine but binds more strongly to dopamine receptors so is more effective in smaller doses
- 4-8mg/day, max 12mg
what’re the bad side effects of risperidone
few, but can still cause agitation, anxiety blurred vision, muscle spasms etc
what’re 2 strengths of drug therapy
meta-analysis
clozapine reliability
what is the meta analysis support for drug therapy (+/-)
- Gilbert found in the m-analysis of 66 studies that 53% relapsed within 10 months of stopping meds
- 16% relapsed who continued
- shows effectiveness especially when taken continually
- however, 53% relapse rates may cause dependency and weaken the drug’s effectiveness in treating Sz
- strengthened by the 16% relapse rates of continuing the drug
how is clozapines reliability a support of drug therapy
- clozapine is effective in patients who other antipsychotics couldn’t treat
- 30-50% of treatment-resistant cases were effectively managed with clozapine
- shows clozapine to be a very effective, reliable drug treatment for when all others fail
whatre 2 limitations of drug therapy
- side effects
- decreased dopamine production
how are side effects a limitation of drug therapy
- range of side effects include: dizziness, agitation, stiff muscles, weight gain and low blood pressure
- for clozapine patients, regular blood tests are needed to watch for development of agranulocytosis (low white blood cell count)
- side effects make the treatment process more stressful for the patient and may detriment their lives
- may lead to going off of the drug due to alternatives eg CBTp
