Schizophrenia - Drug therapy

Question 1

How do antipsychotic drugs work?

Answer 1

They block the receptor sites on the post-synaptic neuron so the dopamine can’t bind with the receptor sites and so can’t transmit its message.

Question 2

How are typical antipsychotic drugs such as Clorpromazine (Thorazine) effective?

Answer 2

• They block D2 receptors in the dopamine pathway, reducing action of dopamine so reduces positive symptoms
• Also an effective sedative, reduces anxiety
• Little effect on negative symptoms

Question 3

What are the side effects of typical antipsychotic drugs?

Answer 3

• Agitation
• Weight gain
• Itching
• Tardive dyskinesia (involuntary facial movements)
• Neuroleptic malignant syndrome (high temperature, delirium and coma)

Question 4

What are the two examples of atypical antipsychotics?

Answer 4

• Clozapine

- Risperidone

Question 5

How is clozapine (atypical antipsychotic) effective?

Answer 5

• Significantly better than all other anti-psychotics
• Binds to D2 receptors but also serotonin and glutamate receptors; reduces positive symptoms and reduces anxiety
• Useful for patients with anxiety
• May help reduce negative symptoms

Question 6

What are the side effects of clozapine (atypical antipsychotic)?

Answer 6

• Reduced risk of side effects
• Drowsiness is a common side effect
• Potentially fatal from rare blood condition

Question 7

How is risperidone (atypical antipsychotic) effective?

Answer 7

• Acts on dopamine and serotonin receptors
• Binds more strongly to D2 receptors than clozapine does, more effective in lower doses
• Reduces positive symptoms and may help reduce negative symptoms

Question 8

What are the side effects of risperidone (atypical antipsychotic)?

Answer 8

• Metabolic changes, weight gain
• Sluggishness
• Fewer side effects than others due to lower doses
• Less likely to produce tardive dyskinesia
• Less risk of fatality than clozapine

Question 9

What is the strength of drug therapy for schizophrenia?

Answer 9

Research support for effectiveness

• Meltzer conducted a review and found clozapine is the most effective antipsychotic drug working for 30%-50% of patients where typical drugs have failed to help
• The treatment therefore does what it is claimed to do
• Therefore the drugs are very useful and can improve people’s wellbeing

Question 10

Why is the fact that drug treatment relies on the dopamine hypothesis being true a limitation?

Answer 10

• Drugs target the dopamine system
• Just because dopamine is associated with schizophrenia does not mean it is the cause of symptoms
• Also the explanation may be over simplified, there are lots of neurotransmitters involved and research is still ongoing
• Therefore although we know the drugs work, we can’t assume that dopamine causes schizophrenia

Question 11

Why is the fact that drug treatment often makes patients experience serious side effects a limitation?

Answer 11

• Some particularly concerning side effects are tardive dyskinesia because they can be permanent
• This means costs can outweigh the benefits for some patients, meaning they won’t take the drugs

Question 12

Why is the fact that drug treatment can be criticised using the chemical cosh argument a limitation?

Answer 12

• It has been suggested that it is unethical to use powerful drugs just to make patients easier to manage.
• They may be medicated for other people’s benefit rather than their own benefit
• This suggests that they may be being used unethically