drug treatments bio exp. Sz Flashcards
(25 cards)
what can we use is Sz is cause by an excess or deficiency of a certain neurochemical?
then medication can be used to correct this imbalance
what are typical antipsychotics?
Dopamine antagonist
reduces positive symptoms by blocking postsynaptic dopamine receptors
what is an issue with typical antipsychotics?
They reduce positive symptoms for many but up to 40% gain no relief at all and still experience negative effects
what is Chlorpromazine?
first antipsychotic medication, discovered in the 1950’s as a tranquilliser.
why is it a problem that chlorpromazine dampens the effects of dopamine in all parts of the brain?
In Szs, dopamine is only in excess in some areas of the brain, dampening dopamine effects in all areas may lead to deficiency in areas that were already at normal level or low.
what can dopamine deficiency in some areas of the brain lead to?
Resulting in motor side effects – feeding persecutory delusions that the doctor is even out to get them
what is haloperidol?
requires less dosage due to higher potency in attempt to reduce severity of motor side effects
would also encourage clients to take the drug more as there is less needed to take so requires less effort.
what are atypical antipsychotics?
Began to look at interactions with other NTs such as serotonin and glutamate as well as dopamine.
why is it beneficial, having less direct target on dopamine
increases the balance between NTs, reducing those motor side effects, increasing adherence and allows for both positive and negative symptoms to be controlled.
what is clozapine?
Clozapine was developed in the 1960s and blocks dopamine in the same way as as FGAs but also acts on serotonin and glutamate receptors.
what is a problem with clozapine?
ultimately reduces both positive and negative symptoms,
side effects still occur such as agranulocytosis
(potentially fatal blood condition whereby the individual has severely low levels of white blood cells)
therefore fallen out of favour
what is clozapine still used for today?
Still used to treat resistant clients, providing relief for up to 60%, regular blood tests must be issued to help avoid agranulocytosis
what is risperidone?
Risperidone is more recently developed
binding to serotonin as well as dopamine but more strongly to dopamine receptors so is effective in much smaller doses
what good. empirical evidence is there for drugs?
from a large meta-analysis
18 antipsychotics were compared to a placebo using data from 56 randomized controlled trials with over 10,00 people
what did empirical evidence from a large meta-analysis find?
Found that 17 of the 18 tested had significantly lower relapse rates than a placebo treatment, avoiding emotional and financial costs of hospital treatments
what have 20% of Sz shown?
little improvements after multiple FGA trials
45% experience partial or inadequate improvements and side effects – failing to function well in everyday life.
what may patients better benefit from along side drug treatments?
unsufficient on their own
May better benefit from ACT that have been found to have clearer effects on the prevention of relapse and rehospitalization.
what is the aim when using drug treatments?
Quicker the medication starts, the more effective treatment will be
Within the first week after psychotic episode, aim is to decrease hostility and return client to normal functioning
what are patients carefully monitored for when using drug treatments?
changes in symptoms and side effects
what is given to patients when symptoms and side effects begin to subside?
maintenance dose is prescribed to encourage socialization, self-care and combat relapse (occurring in 60-80% of people)
should be maintained for at least 12 months after remission.
what can disrupt the effectiveness of antipsychotics?
Amphetamines, alcohol, caffeine and nicotine can all disrupt the effectiveness of antipsychotics
what are some additional considerations in drug treatment?
support for substance abuse should also be considered in treatment. Increasing effectiveness by eliminating extraneous variables
what do supporters of the anti psychiatry movement believe?
call drug treatments chemical straitjackets leading to disempowerment
believing its wrong that some people in society have the power to control others using drugs to change their behaviour
what do antipsychotics mean for how people with Sz live their lives?
having the chance to remain in the community
