Drug Therapy For Schizophrenia Flashcards
What is the most common treatment for schizophrenia?
The most common treatment for schizophrenia is antipsychotic drugs.
What is the background behind typical antipsychotics?
-They are Antagonistic drugs in use since the 1950s.
-were initially developed as an antihistamine to treat allergies, but had surprising beneficial effects on reducing mania, agitation and other conditions.
What is ab example of a typical antipsychotic?
Chlorpromazine:
-The first antipsychotic drug used to treat psychosis
How do typical antipsychotics work (mode of action)?
They tightly bind to dopamine receptors
(mainly the D2 subtype) without activating them.
-Slowly dissociate from the receptors.
-This greatly decreases the ability of dopamine to bind to the receptors, which greatly decreases overall activity at dopamine synapses.
What are the effects of typical antipsychotic on symptoms?
Significantly decreases many positive symptoms of schizophrenia, especially hallucinations and delusions
What are the side effects of typical antipsychotics?
Extrapyramidal side effects can occur which often involve
-Agranulocytosis occurs in 1% of patients in movement deficits. This is because dopamine plays an important role in motor control.
-Tardive dyskinesia develops in 15% of long-term users of typical anti-psychotics.
-This involves unwanted movements of tongue, face and jaw.
What is the background of atypical antipsychotics (second generation)?
-Antagonistic drugs in use since the 1970s.
-They are mainly used in schizophrenia patients who are unresponsive or intolerant of other’antipsychotics.
What is an example of an atypical antipsychotic?
Clozapine: The first atypical antipsychotic drug used
How do atypical antipsychotics work (mode of action)?
-Loosely bind and quickly dissociate from dopamine (D2) receptors without activating them.
-Dopamine is therefore able to outcompete the drug for limited access to receptors.
-This somewhat decreases overall activity at dopamine synapses.
-Also binds to serotonin (5-HTza) receptors (linked to mood) and glutamate receptors (linked to anxiety).
What are the effects of atypical antipsychotic drugs on symptoms?
-Decreases many positive symptoms of schizophrenia, especially hallucinations and delusions.
-Also decreases negative symptoms such as cognitive impairment, including speech poverty.
-Other benefits include a decrease in avolition and suicidal thoughts - which affect 30-50% of schizophrenic patients.
What are side effects of typical antipsychotics?
Neuroleptic Malignant Syndrome- too many D2 receptors are blocked by a particular pathway to the hypothalamus- can cause body to overheat- cause coma and death
