L8: Drug Therapy - Typical/Atypical Drugs

Question 1

What are typical antipsychotic drugs?

Answer 1

• Chlorpromazine & Phenothiazine
• Available as tablet, syrup, injection
• Effective sedative

Question 2

What do typical drugs do?

Answer 2

• Less popular than atypical
• Reduce positive symptoms
• Reduce dopamine levels, acting like dopamine antagonists. They bind to receptors.
• Drug must bind to 60-75% of receptors and block their activity to be effective

Question 3

Evaluation of Typical drugs (+)

Answer 3

(+) Supporting evidence says that typical drugs are effective in tackling symptoms. He compared Chlorpromazine to a placebo and found that patients had better functioning and reduced severity of symptoms when they took CP instead of the placebo. Relapse rate was lower.
(+) Cheap to produce and administer to help people love a normal life outside institution. 97% of patients would live at home

Question 4

Evaluation of Typical drugs (-)

Answer 4

(-) Terrible side effects for long term - ‘Tardive Dyskinesia’ where mouth muscles make involuntary movement
(-) Problem with long term. 2% develop Neuroleptic malignant syndrome - can lead to coma
(-) Reduce positive effects but not negative effects.
(-) Side effects where dysfunction occurs in nerve tracts from the brain and spinal motor neurones. Side effects can resemble Parkinson’s.

Question 5

What are Atypical Antipsychotics

Answer 5

• Alternative drugs like Risperidone and Clozapine
• Drugs block the activity of dopamine within the brain
• Drugs temporarily occupy receptors and allow normal dopamine transmission
• Increase serotonin to improve mood
• Fewer side effects than Typical
• Reduce both positive and negative symptoms

Question 6

Describe an atypical drug

Answer 6

Clozapine

• Given when patient is suicidal
• Binds to dopamine receptors but acts on serotonin and glutamate
• Improves mood, reduction of anxiety/depression, can improve cognitive function

Question 7

Atypical Evaluation (+)

Answer 7

(+) Most effective treatment compared to other forms of therapy
(+) Clozapine is a more effective drug than typical anti-psychotic drugs. Found 30-50% more effective than typical drugs when lowering symptoms

Question 8

Atypical Evaluation (-)

Answer 8

(-) Treats symptoms, but not cause. Symptoms might return if patients stop taking drugs. ‘Revolving Door Phenomenon’, whereby patients leave the hospital and then return because drugs have failed
(-) Some patients are resistant, as results from trials can be inconclusive about effectiveness. Some drugs won’t work because of individual differences.
(-) Ethical issues - drugs do not help the patient but gains to control them, make them easier to manage
(-) Serious side effects where bone marrow is affected and less white blood cells are produce, affecting immunity to illness