SCHIZOPHRENIA : BIOLOGICAL THERAPY Flashcards
what are antipsyhcotics
drugs used to reduce intensity of symptoms,
in particular +Ve symptoms of psychotic disorders liek schizophrenia
all antipsyhcotic drusg work as
dopamine antagonsits
what does working as dopamine antagnosist mean
reduction the action of dopamine in areas of the brai associted with symptoms of schizophrenia
what are the 2 types of antipsychotic drusg
typical/conventional
atypical
typical antipsychtoic developed in the
1950s
typical antipsychotics were the first
gerneatin of antipsychotics
give me an example of a typical antipsychotic
chlorpromazine
explai how typical antipsychotics such as chlorpromazine work as dopamine antagonists
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
what did the discovery of the antagnosit effect do
led to devlopmetn of dopamine hypothesis
what is the problem with blocking dopamine receptors in the way atypical drugs/antipsychotics do
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
tell me anout undesirable side effects
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
as well as being an antipsychotic what can chloropromazine is also an effcetove
sedative
since chloropromazine is also a sedative whar is it often used to do
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
what are atypical antipsychotics
drusg for schixophrenia developed after antipsychotics
typically target a range of nt such as dopmaine and serotinin
2nd gen
when were atypical antipsychotics deelpoed
60s and 70s
what were atypical antipsychtoic designed to do
maintian effectiveness of typical drugs whilst reducing side effects
how do atypical antipsychotics work
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
atypical antipsychotics have got less x x side effects
extra pyrimidal side effects
why have atyipical antipsychotics got less extra pyrimidal side effects
thought to be result of temp binding to receptors
atyical anitpsychotics also act on
serotinin and glutamate receptors
becuase atypical antipsyhotics also acto on serotinin and glutamate receptors and its thought this action helps to
improve
mood
cognitive functions
lower depression and anxiety
meaning they can effect both +ve and -ve symptoms
mood enhancing effect of atypical antipsychotics means theyre sometimes
prescribe to patients who ar eat risk of suicide
which is important given 30-50% of people with schizo attempt suicide at some poitn
what are our eval points
evidence of effectivness
side effects
chemical cosh
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.
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.
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.
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.
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
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
strenhr - removes blame
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.
