Schizophrenia - Drug Therapy

Question 1

Explain typical antipsychotics

Answer 1

they work by acting as antagonists in the dopamine system + aim to reduce the action of dopamine - strongly associated with dopamine hypothesis

Question 2

Explain how dopamine antagonists work

Answer 2

by blocking dopamine receptors in the synapses in the brain - reducing the action of dopamine.
Initially dopamine levels build up after taking chlorpromazine but then production is reduced.
This normalises neurotransmission in key areas of the brain, which in turn reduces symptoms like hallucinations

Question 3

What effect does Chlorpromazine also have

Answer 3

effect on histamine receptors therefore it is also used to calm anxious patients when they are first admitted to hospital - sedation effect

Question 4

give an example of a typical antipsychotic

Answer 4

chlorpromazine

Question 5

give an example of an atypical antipsychotic

Answer 5

clozapine

Question 6

What do atypical antipsychotics do

Answer 6

target dopamine and serotonin

improve the effectiveness of drugs is suppressing psychosis such as SZ and minimise side effects

Question 7

What does clozapine do

Answer 7

binds to dopamine receptors like chlorpromazine but also acts on serotonin and glutamate receptors.

Question 8

were atypical antipsychotics or typical psychotics more effective

Answer 8

Clozapine was more effective (atypical) as clozapine reduces depression + anxiety in patients as well as improving cognitive functioning
it also improves mood which is important as 50% of SZ patients attempt suicide

Question 9

What is another atypical antipsychotic other than clozapine?

Answer 9

Risperidone

Question 10

Why was Risperidone developed

Answer 10

because clozapine was involved in the deaths of some patients with a blood condition called agranulocytosis

Question 11

How does Risperidone work

Answer 11

binds to dopamine and serotonin

Question 12

Why is Risperidone more effective

Answer 12

it binds more strongly to dopamine and so can be used in smaller doses as it is more effective and has fewer side affects

Question 13

give two studies who supports drug therapy

Answer 13

Thornley et al (2003) shows antipsychotics are moderately effective
Meltzer (2012) support for the benefits of atypical antipsychotics

Question 14

What did Thornley et al (2003) do and find

Answer 14

reviewed data from 13 trials (1121 participants) + found that chlorpromazine was associated with better functioning and reduced symptom severity compared with a placebo

Question 15

What did Meltzer (2012) conclude

Answer 15

clozapine is more effective than typical antipsychotics + that it is 30-50% more effective in treatment

Question 16

Give three limitations of antipsychotics

Answer 16

side effects
not really effective
chemical cosh

Question 17

Explain side effects as a limitation of antipsychotics

Answer 17

associated with dizziness, agitation,slepiness and weight gain the most serious side effect is neuroleptic malignant syndrome caused by blocking dopamine action in the hypothalamus which can be fatal due to disrupted regulation of several body systems

Question 18

Explain doubts to true effectiveness using a study as a limitation of antipsychotics

Answer 18

Healy(2002) sugests data from successful trials have been published many times exaggerating positive effects. Also as antipsychotics have powerful calming effects it can be easy to demonstrate the + effects despite the fact it might not be effective for psychosis

Question 19

What is the conclusion to Healy (2002)

Answer 19

This suggests the effectiveness of antipsychotics may be overestimated by much of the empirical research

Question 20

Explain chemical cosh as a limitation to antipsychotics

Answer 20

APSYC used in hospitals to calm patients so they are easier to work with rather than benefiting the patient themselves (short term) which is recommended by NICE
However this may abuse HR and raises ethical issues in the use of APSYC in SZ