Drug treatments for schizophrenia

Question 1

What are antipsychotics also known as?

Answer 1

• Dopamine antagonists.

Question 2

How do antipsychotics work?

Answer 2

• All antipsychotics work by reducing dopaminergic transmission.
• They block receptors and reduce DA at the synapse, meaning their is less opportunity for dopamine binding.
• They aim to reduce the action of dopamine in areas of the brain associated with schizophrenic symptoms (e.g. Broca’s area, pre-frontal cortex).

Question 3

What are the 2 types of antipsychotics?

Answer 3

1. Typical antipsychotics.
2. Atypical antipsychotics.

Question 4

Examples of typical antipsychotics…

Answer 4

• Chlorpromazine.
• Haloperidol.

Question 5

General info about antipsychotics

Answer 5

• Used to primarily combat positive symptoms.
• Has a calming and sedative effect.
• Side effects: affects motor skills, tardive dyskinesia, sleepiness, dry mouth, EPS.

Question 6

What is tardive dyskinesia?

Answer 6

• Results in involuntary, repetitive muscle movements.

Question 7

What is EPS?

Answer 7

Extra-Pyramidal side effects:
- Motor control and coordination.
- Unable to control motor movements.

Question 8

How do typical antipsychotics work?

Answer 8

• Block the post-synaptic dopamine receptors and reduces the chances of dopamine being received.

Question 9

Examples of Atypical antipsychotics….

Answer 9

• Clozapine.
• Risperidone.

Question 10

General info about atypical antipsychotics

Answer 10

• Reduces both positive and negative symptoms.
• Also acts on other neurotransmitters (e.g. serotonin).
• Less/ fewer side effects than ‘typical’ antipsychotics.
• Side effects= agranulocytosis which can be fatal (reduction in white blood cells leading to an ineffective immune system).

Question 11

Research study for chlorpromazine (Typical)

Answer 11

Barlow and Durand
- Chlorpromazine is effective in reducing schizophrenic symptoms in about 60% of cases.
- Most impact on positive symptoms; treated patients may still suffer negative symptoms.

Question 12

Research studies for haloperidol (Typical)

Answer 12

Schooler
- Randomly allocated 555 patients in the first episode of schizophrenia to either treatments with haloperidol or risperidone.
- In both groups 75% of patients showed a reduction in symptoms.

Question 13

Research studies for clozapine (Atypical)

Answer 13

Pickar
- Compared clozapine with other neuroleptics and a placebo and found clozapine to be the most effective in reducing symptoms, even in patients who had previously been treatment resistant.

Question 14

Research studies for risperidone

Answer 14

Emsley
- Found that patients who were injected with risperidone early in the course of disorder had low relapse rates and high remission rates.
- 84% of patients showed at least a 50% reduction in both positive and negative symptoms, and 64% went into remission.