Drug treatment of SZ Flashcards
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Drugs for schizophrenia were first developed in the 1950s and were known as typical antipsychotics - chlorpromazine is an example.Patients did not like taking them though as they had unpleasant side effects.In the 1990s newer drugs were developed called atypical antipsychotics e.g risperidone and clozapine.
The typical antipsychotics were good at treating positive symptoms but not negative symptoms.Clozapine however seems to be able to treat some negative symptoms too.Antipsychotics lower levels of dopamine by blocking dopamine receptors.In particular they act on D2 receptors.Some newer drugs block 5-HT2A receptors which lowers serotonin.
Drugs can be administered through tablet form or injection.
Patients should continue with medication for at least 6 months if the response is good.The drug may gradually be withdrawn if the patient is symptom free for 1 year.However, if the patient experiences 2 relapses within a 5 year period it may be recommended that they continue with the medication indefinitely.
Strengths of Drug treatment
What did Carlsson find?
What can drug therapy allow patients to access more easily?
-Carlsson et al 2000, reviewed studies and found clozapine to be highly effective in treating negative symptoms too, with fewer reported side effects, and effective for those who have previously not responded to treatment.
-It can begin to reduce severe symptoms within a few weeks so possibly avoid hospitalisation, plus, allow the patient to access other therapies such as CBT which might not be possible whilst symptoms such as delusions and disorganised speech are still severe.
What side effects can occur? What can this lead to?
Why can drug therapy be considered unethical?
-Drugs can produce side effects (e.g. drowsiness, blurred vision) which might mean patients are not compliant which can lead to relapse; some side effects are severe, e.g. clozapine can reduce the white blood count.Lieberman et al 2005 found that often patients stop taking their medication due to side effects being too severe, which affects the effectiveness of drug therapy.
-There are issues of social control and the therapist has the power; typical antipsychotics also made patients passive so they may have been given to make them easier for staff to deal with. Section 3 MHA explains that drugs can be administered without consent (only in extreme cases).
Is drug therapy a cure?
Why might drug therapy be ‘easier’?
-Drug therapy is not a cure, it just treats the symptoms not the underlying cause, so when medication is stopped, symptoms may return.
-Alpert and Friedhoff found that some people do not respond to antipsychotics at all.
-It is less effort on patient and clinicians behalf and because of this some doctors have been criticised for over relying on drugs as an ‘easy’ option.
