schizophrenia🫂 (drug therapy) Flashcards
what do antipsychotics aim to do?
try to reduce the serveity of positive symptoms.
what are typical antipsychotics?
example of it, when was it developed?
how can they be taken?
work as dopamine antagonists
chlorpromazine, developed in 1950s.
tablets, injection, syrup, ( if taken oral max 1000mg)
what do typical drugs work as?
antagonists in dopamine system bc of association w dopamine hypothesis
what r antagonists?
chemicals which reduce action of neurotransmitter
how do typical antipsychotics first work?
builds up dopamine lvls but then production is reduced. dopamine antagonist effect normalises neurotransmission in key areas of brain, reducing hallucination symptoms.
how to dopamine antagonists work?
by blocking dopamine receptors in synapse of brain.
when is it often given? and what can it be used for? (typical antipsychotics)
when patients are first admitted they’re anxious, thus it can be used through syrup as a sedative
what are atypical antipsychotics?
what do they focus on?
what are the 2 types?
developed in 1970s, to improve the effectiveness of drug in suppressing symptoms of psychosis and minimise side effects.
multiple neurotransmitters- dopamine and serotonin
clozapine & risperidone
what is clozapine/ when was it developed?
what does it have an effect on?
1960s but withdrawn for a while in 70s due to patients dying from blood condition- agranulocytosis.
mood enhancing, thus its sometimes prescribed when patients r high risk of suicide
what was clozapine thought to be?
more effective than typical antipsychotics
what do ppl who take clozapine have to have?
have regular blood tests to ensure they don’t develop agranulocytosis
what is clozapine not available through?
injection, due to fatal side effects. dosage also has to be smaller.
what does clozapine bind to?
dopamine receptors in the same way chlorpromazine does. but also acts on serotonin + glutamate receptors- thought to improve mood and reduce depression in patients.
what is risperidone? when was it developed?
1990s, developed in attempt to be as effective as clozapine without serious side effects
how is risperidone taken?
can be taken via tablet, syrup, injection. lasts for around 2 weeks and is given thru small dosage.
what does risperidone bind to?
dopamine and serotonin receptors but binds more strongly to dopamine receptors than clozapine, thus its more effective in small doses and leads to fewer side effects
AO3✅
what is a strength of antipsychotics?
evidence for effectiveness
research reviewed studies comparing effects of chlorpromazine to control conditions In which patients received placebo. experiments were identical other than the drug they took. results showed that chlorpromazine was associated w better overall functioning and reduced severity of symptoms. relapse rates also found lower when chlorpromazine was taken.
in addition there was support for benefits of atypical antipsychotics. research showed that clozapine was more effective than typical antipsychotics. 30-50% of treatment resistance cases were typical antipsychotics have failed
AO3❌
2 weaknesses of drug therapy?
serious side effects. associated w weight gain, itchy skin, stiff jaw, dizziness and agitation, long term results in tar dive dyskinesia, which is caused by dopamine super sensitivity and manifests involuntary face movements ie upper lip shaking and blinking. most serious side effect is neuroleptic malignant syndrome, where the drug blocks dopamine action in the hypothalamus, which is associated w regulation of number of body systems. this can result in high temp/coma. atypical drugs were developed to reduce side effects however they do still exist and ppl have to take regular blood tests bc of agranulocytosis.
its unethical. patients have been sedated by there drugs to calm them down. this makes it easier for staff working with them rather than benefitting the patient. using typical antipsychotics for this reason is recommended by national institute for health and clinical excellence, which can be seen as human rights abuse. can be considered unethical bc they’re controlling the patients behaviour however it may be necessary as it stops patient from hurting themselves or others. drugs can be said to dehumanise individual as they take away personal responsibility and the patient themselves cannot consent to the treatment. if they’re sectioned, treatment can also be enforced.
