SCHIZOPHRENIA : BIOLOGICAL THERAPY

Question 1

what are antipsyhcotics

Answer 1

drugs used to reduce intensity of symptoms,

in particular +Ve symptoms of psychotic disorders liek schizophrenia

Question 2

all antipsyhcotic drusg work as

Answer 2

dopamine antagonsits

Question 3

what does working as dopamine antagnosist mean

Answer 3

reduction the action of dopamine in areas of the brai associted with symptoms of schizophrenia

Question 4

what are the 2 types of antipsychotic drusg

Answer 4

typical/conventional

atypical

Question 5

typical antipsychtoic developed in the

Answer 5

1950s

Question 6

typical antipsychotics were the first

Answer 6

gerneatin of antipsychotics

Question 7

give me an example of a typical antipsychotic

Answer 7

chlorpromazine

Question 8

explai how typical antipsychotics such as chlorpromazine work as dopamine antagonists

Answer 8

reduce action of dopamine by binding to dopmaine receptors on psotynaprtic neuron w/o stimulating them

therfore preventing dopamine from binding to dopamine receptors

this normalises neurotransmission in key areas of the brain therfore reduce positive symptoms e.g hallucinations

Question 9

what did the discovery of the antagnosit effect do

Answer 9

led to devlopmetn of dopamine hypothesis

Question 10

what is the problem with blocking dopamine receptors in the way atypical drugs/antipsychotics do

Answer 10

research suggest 60-70% of dopamine receptors in MESOLIMBIC DOPMAINE PATHWAY must be blocked for drugs to be effective

to achieve this a numebr of dompaine receptors in other areas of the brin must aslo be blocked leading to undesirable side effects

Question 11

tell me anout undesirable side effects

Answer 11

developmetn of extra pyramidal side effect such as tardive dyskinesis

this is involuntary movemtn of tongue , face , jaws

these durgs effcet extra pyramidal area of the brain which helps ctrl motor activity

Question 12

as well as being an antipsychotic what can chloropromazine is also an effcetove

Answer 12

sedative

Question 13

since chloropromazine is also a sedative whar is it often used to do

Answer 13

calm indis with schizophrenia as well as those that dont suffer

often done when 1st admitted to hospital and pt very anxious/middle of psychotic break

Question 14

what are atypical antipsychotics

Answer 14

drusg for schixophrenia developed after antipsychotics

typically target a range of nt such as dopmaine and serotinin

2nd gen

Question 15

when were atypical antipsychotics deelpoed

Answer 15

60s and 70s

Question 16

what were atypical antipsychtoic designed to do

Answer 16

maintian effectiveness of typical drugs whilst reducing side effects

Question 17

how do atypical antipsychotics work

Answer 17

work in same way as typical

block dopamine receptors without stimulating them

but only temporarily occpuying receptors before rapidly disassociating and allwoing normal dopmainetransmission to occur

Question 18

atypical antipsychotics have got less x x side effects

Answer 18

extra pyrimidal side effects

Question 19

why have atyipical antipsychotics got less extra pyrimidal side effects

Answer 19

thought to be result of temp binding to receptors

Question 20

atyical anitpsychotics also act on

Answer 20

serotinin and glutamate receptors

Question 21

becuase atypical antipsyhotics also acto on serotinin and glutamate receptors and its thought this action helps to

Answer 21

improve
mood
cognitive functions
lower depression and anxiety

meaning they can effect both +ve and -ve symptoms

Question 22

mood enhancing effect of atypical antipsychotics means theyre sometimes

Answer 22

prescribe to patients who ar eat risk of suicide

which is important given 30-50% of people with schizo attempt suicide at some poitn

Question 23

what are our eval points

Answer 23

evidence of effectivness

side effects

chemical cosh

Question 24

explain eval - evidence of effectivness

Support for the effectiveness of antipsychotics comes from studies that have compared relapse rates for X and X.

X et al (2012) carried out a X-X
of X studies.
All patients had been stabilised on either typical or atypical antipsychotics. Some of these
patients were X X their antipsychotic medication and given a X instead.

The remaining patients remained on their regular antipsychotic. Within X months, X% of those patients who had been given the placebo had X, compared to X% of those who stayed on the X drug.
This shows drug therapy is effective as it demonstrates that it is the X-X properties of the drug
which are X the recovery not simply the X influence of being X a
medication.

Answer 24

Support for the effectiveness of antipsychotics comes from studies that have compared relapse rates for antipsychotic and placebos. Leucht et al (2012) carried out a meta-analysis
of 65 studies.
All patients had been stabilised on either typical or atypical antipsychotics. Some of these
patients were taken off their antipsychotic medication and given a placebo instead.
The remaining patients remained on their regular antipsychotic. Within 12 months, 64% of those patients who had been given the placebo had relapsed, compared to 27% of those who stayed on the antipsychotic drug.
This shows drug therapy is effective as it demonstrates that it is the bio-chemical properties of the drug
which are influencing the recovery not simply the psychological influence of being prescribed a
medication.

Question 25

side effects -

A limitation of drugs are the side effects that they can lead to. Typical antipsychotic drugs
can sometimes produce X problems for the patient. The most common resemble the features of X X .
More than X of the patients taking X
antipsychotics experience these symptoms. Long term use can lead to X X
These side effects can be so X for the patient that
other X have to be given to control them, or the patient may X taking their antipsychotic
medication completely.
This is therefore a weakness of drug therapy as patients may be X to
continue to take the drugs if they continue to experience these X symptoms.

Answer 25

A limitation of drugs are the side effects that they can lead to. Typical antipsychotic drugs
can sometimes produce movement problems for the patient. The most common resemble the features
of the neurological disorder Parkinson’s disease (PD). More than half of the patients taking typical
antipsychotics experience these symptoms. Long term use can lead to tardive dyskinesia i.e. involuntary
movements of the tongue, face and jaw. These side effects can be so distressing for the patient that
other drugs have to be given to control them, or the patient may stop taking their antipsychotic
medication completely. This is therefore a weakness of drug therapy as patients may be un-willing to
continue to take the drugs if they continue to experience these unpleasant symptoms.

Question 26

eval - chemical cosh

use poses a bit of a X dilemma

on one hand XX use of AP is recommended and X pt distress by hallucination and delusion and they allow pt to engage w other X e.g CBT

on the other hand its widely believed theyve been used in hospital tratments to X people with schizo and make them X for X tow ork with - amost reduces them to X state
rather than X the people themelf

furthermore drugs canbe argued to be X as take away and individuals personal X and X whne they may not have necessarily X to treatment as they may not be in a X to prtclry in a X state

therfore X should be reserved for pt xp great levels of X which may X htem from accessing X treatments and ultimatly X with recovery rather than being the first X treatment

Answer 26

use poses a bit of a moral dilemma

on one hand st use of AP is recommended and calm pt distress by hallucination and delusion and they allow pt to engage w other treatmens e.g CBT

on the other hand its widely believed theyve been used in hospital tratments to calm people with schizo and make them easier for staff tow ork with - amost reduces them to zombie state
rather than beenfiting the people themelf

furthermore drugs canbe argued to be dehumanising as take away and individuals personal respobsilty and contrl whne they may not have necessarily consente to treatment as they may not be in a positon to prtclry in a psychptic state

therfore prescriotin should be reserved for pt xp great levels of distress which may prevent htem from accessing aternative treatments and ultimatly progressing with recovery rather than being the first step treatment

Question 27

strenhr - removes blame

Answer 27

One reason it can be argued that drugs are suitable is because they remove any
blame from the patient. By treating purely biological factors, schizophrenia is viewed as having a
biological cause. This can be positive for the patient as they may be more inclined to seek treatment if
they do not feel that they are being judged in any way.