S4. Biological Therapies (Drug Treatment)

Question 1

Antipsychotics

Answer 1

• dopamine antagonists (inhibitors)
• bind to complementary receptors on post-synaptic neurone, stopping dopamine neurotransmission

Question 2

Types of Antipsychotics

Answer 2

Typical and Atypical

Question 3

Typical Antipsychotics

Answer 3

• ‘first generation’ (first prescribed for SZ)
• eg. Chlorpromazine (calming and sedative)
• acts upon histamine and dopamine receptors

Question 4

Atypical Antipsychotics

Answer 4

• ‘second generation’ (adds to effectiveness of first gen.; and alleviates side effects)
• acts upon other neurotransmitters receptors on post-synaptic membranes
• e.g. Clozapine (targets serotonin and glutamate receptors)
• e.g. Risperidone (targets serotonin and dopamine receptors)

Question 5

Clozapine advantage

Answer 5

• patient improvement in cognitive function and mood
• however, offset by ‘agranulocytosis’ side effect

Question 6

Rispoeridome advantage

Answer 6

• smaller doses required than Clozapine (acts more strongly on dopamine receptors)
• safer for patient who have history of blood related illness (avoids potential ‘agranulocytosis’)

Question 7

• Eval: Antipsychotic Development based upon Dopamine Hypothesis

Answer 7

• original hypothesis (DH) attributes excess dopamine SZ
• revised hypothesis attributes lack of dopamine SZ
• therefore, a further reduction in dopamine should worsen symptoms, NOT alleviate them (as suggested by the DH)
• validity of antipsychotics questioned, as well as DH as an explanation for SZ

Question 8

• Eval: Side-Effects

Answer 8

• short-term (agitation, weights gain) = mild
• long term (tardive dyskinesia, NMS, agranulocytosis)

Question 9

Tardive Dyskinesia

Answer 9

involuntary contraction and relaxation of facial muscles

Question 10

Neuroleptic Malignant Syndrome (NMS)

Answer 10

• causes: dopamine receptor blockage, CNS infections
• characterised: fever, altered mental states, muscle rigidity, autonomic dysfunction
• NOT offset by atypical antipsychotics (‘agranulocytosis’ side effect still present, continually monitored -blood tests)

Question 11

• Eval: Validity of Antipsychotics

Answer 11

• studies ‘reviewing effectiveness’ instead only review how ‘calm and functional’ the patient is
• suppressing symptoms ≠ controlling them (studies lack face validity)