Schizophrenia - biological therapies Flashcards
1
Q
Adams - drug treatments
A
- reviewed trials in whcih chlorpromazine was compared to placebo
- 348 trials but 299 were excluded for flaws in research methods
- randomised control trials
- chlorpromazine reduces relapse rates over short and medium term, data was varied
- global improvement in person’s symptoms and functioning
2
Q
NICE - drug treatments
A
- up to 40% of patients have poor response to typical antipsychotic drugs
3
Q
Essali - drug treatments
A
- reviewed effects of clozapine in people with S compared to typical anti psychotics
- all randomised control trials
- clozapine was more effective in general and for those who did not improve with typical anti psychotics
- clozapine = fewer relapses and showed greater reduction of symptoms
- data was varied (heterogeneous)
- blood problems occurred in 3.2% more for those receiving clozapine, experienced less motor adverse effects
- trials could be biased as favoured clozapine; cherry picking?
4
Q
Davis - drug treatments
A
- found that 33 out of 42 reports were sponsored by drug company of which 90% of the studies reported overall outcome in favour of the sponsor’s drug
- suggests some source of bias which limits validity
5
Q
Tharyan and Adams - ECT
A
- meta-analysis
- randomised control trials comparing ECT to sham procedure
- more patients improved in real ECT group
- ECT seemed to result in less relapses in the short term, no evidence for medium/long term
- when ECT was compared to antipsychotic drug treatment the results favoured drug treatments
- limited evidence for ECT and drug treatments as better than drugs alone
- large number of trials and participants
- included all trials
6
Q
Greenhalgh - ECT
A
- multiple databases
- no randomised evidence of effectiveness of ECT in subgroups
- much less evidence for efficiency of ECT in schizophrenia and mania
- need for further high quality randomised trials for use of ECT in specific subgroups
