Schizophrenia: Biological treatments Flashcards
What is the main biological treatment for SZ?
drug therapy
Name the 2 types of drugs used to treat SZ
typical anti-psychotics
atypical anti-psychotics
State when TYPICAL anti-psychotics were introduced and give a named example
introduced in 192
eg. Chlorpromazine
Typical anti-psychotics are known as …
What does this mean?
dopamine antagonists
they work against the action of dopamine
Describe how typical anti-psychotics work as dopamine antagonists …
3 points
-they block the action of D2 receptors on the post synaptic neuron
-they do this by binding to receptors but not stimulating them
-this decreases the action of dopamine in the synapse
Which type of SZ symptoms do typical APs reduce?
What kind of effect do they have ?
positive symptoms
they have a calming and sedative effect
State when atypical anti-psychotics were introduced
Give 2 examples of atypical APs
introduced in the 1970s
eg. Chlozapine , respiridone
How do atypical APs work?
3 points
-they block dopamine receptors
-they also act on other neurotransmitters such as serotonin and acetylcholine
-they only bind temporarily to D2 receptors and then rapidly dissociate to allow normal dopamine transmission
What symptoms do atypical anti-psychotics address?
both positive and negative sysmptoms
Evaluate the appropriateness of typical anti-psychotics
(its a weakness)
-they can have negative side effects
common ones include constipation or a dry mouth and 20-25% of patients suffer side effects that involve tremors (eg Tardive Dyskinesia)
these symptoms are often permanent which results in around 50% of patients stopping taking them within 1 year , this limits the appropriateness of them as a treatment
Evaluate the effectiveness of typical anti-psychotics
(its a strength , give a however point)
+research support from Thornley 2003
reviewed 50 randomised trials including over 1500 ppts and found that Chlorpromazine reduces relapse over 6 months to 2 years and has promoted a global improvement in patients symptoms and functioning compared to a placebo , suggesting they are effective as a treatment
HOWEVER … a substantial proportion of people are drug resistant , they are also ineffective at treating negative symptoms and many studies focus on the short term effects only therefore there is a need to assess the long term benefits , suggesting typical APs are not effective for everyone
Evaluate the appropriateness of atypical APs
(its a weakness)
-there are negative side effects
for example agranulocytosis which is an auto immune disease that leads to extreme lowering of WBC count and high risk of serious infection
this means patients have to have their blood monitored monthly and in some cases symptoms such as paranoia are worsened
Evaluate the effectiveness of atypical APs
(its a strength)
+Meltzer 2012 concluded that Chlozapine is more effective at reducing both positive and negative symptoms than typical APs , even drug resistant patients showed an improvement in symptoms which shows atypical APs are ore effective at treating SZ
Give a general strength of drug therapies as a treatment for SZ
+there are positive economic implications of drug therapies
drugs are cheaper than other forms of therapy , and they can lead to an enhanced quality of life such as patients being able to live independently/ out of institutional care
they also enable patients to return to work
this suggests that drug therapies are a successful treatment for SZ
Give 2 general weaknesses of antipsychotics as a biological treatment of SZ
-biological therapies are based on biological explanations which are reductionist meaning a wide variety of psychological factors are pushed aside limiting the effectiveness of them
-drugs only treat the symptoms and don’t tackle the environmental factors or causes of SZ
