Schizophrenia: Drug Therapy - Typical/Atypical antipsychotics

Question 1

What type of drug is the most common treatment for schizophrenia?

Answer 1

Antipsychotic drugs

Question 2

Is antipsychotic drugs the most or least common treatment for schizophrenia?

Answer 2

Most

Question 3

What factor should you consider when choosing the right course length of antipsychotics?

Answer 3

Depending on the severity of their psychosis

Question 4

What are the two types of anti-psychotic drugs?

Answer 4

Typical and atypical

Question 5

Which type of drugs are used more often and why?

Answer 5

Typical anti-psychotics are used more often because atypical antipsychotics are associated with a life threatening blood condition (angranulocytosis) where there are low levels of white blood cells.

Question 6

When would an individual use atypical anti-psychotic drugs?

Answer 6

If symptoms do not improve

Question 7

Name a Typical antipsychotic drug

Answer 7

Chlorpromazine

Question 8

How do dopamine antagonists work?

Answer 8

They reduce levels of dopamine activity in the brain by binding to the D2 receptors on the post synaptic neurons in the brain.

Question 9

Explain why Chlorpromazine are dopamine antagonists

Answer 9

Chlorpromazine reduces levels of dopamine activity in the brain

Question 10

Chlorpromazine works by ___________ to the _____ receptors on _____ synaptic neurons in the brain, reducing the action of____________.

Answer 10

binding
D2
post
Dopamine

Question 11

Chlorpromazine works by binding to what?

Answer 11

D2 receptors on post synaptic neuron

Question 12

What happens to dopamine levels when Chlorpromazine binds to the D2 receptors?

Answer 12

Reduces the action of dopamine.

Question 13

What happens to individuals’ symptoms of schizophrenia when taking Chlorpromazine?

Answer 13

Reduces positive symptoms of schizophrenia such as hallucinations and paranoia.

Question 14

Name an atypical drug used to treat schizophrenia.

Answer 14

CLOZAPINE

Question 15

Atypical antipsychotics act upon which neurotransmitter(s) ?

Answer 15

Dopamine and Serotonin.

Question 16

What type of drugs act upon Dopamine AND Serotonin in the brain?

Answer 16

Atypical antipsychotics e.g. Clozapine

Question 17

Clozapine also binds to what receptors sites?

Answer 17

D2 dopamine receptor sites

Question 18

What happens to individuals’ symptoms of schizophrenia when taking Clozapine?

Answer 18

Reduces positive symptoms such as hallucinations.

AND

Reduces negative symptoms of schizophrenia such as a lack of emotions.

Question 19

Why do atypical drugs like clozapine act as agonists?

Answer 19

Increase levels of serotonin.

Question 20

Clozapine increases levels of serotonin in the brain. How does this affect symptoms of schizophrenia?

Answer 20

Reduces negative symptoms of schizophrenia such as a lack of emotions as it helps improve mood and reduce depression and anxiety in patients.

Question 21

Why do Atypical antipsychotics (clozapine) have fewer side effects than typical antipsychotics (chlorpromazine)?

Answer 21

Atypical antipsychotics they have less action on the dopamine system.

Question 22

Why are typical antipsychotics are used first?

Answer 22

This is because atypical antipsychotics (clozapine) are associated with a life-threatening illness (agranulocytosis).

Question 23

What is Agranulocytosis?

Answer 23

Agranulocytosis is a blood condition where there are low levels of white blood cells, preventing and individual fighting of disease and illness.

Question 24

When are atypical antipsychotics (clozapine) used as opposed to typical antipsychotics?

Answer 24

Atypical antipsychotics (clozapine) are only given if typical antipsychotics (chlorpromazine) are not effective or if the patient has severe negative side effects.

Question 25

AO3: Evidence to support the EFFECTIVENESS of antipsychotics as a treatment of schizophrenia comes from…

Answer 25

Thornley et al. (2003)

Question 26

AO3: What large body of research did Thornley et al (2003) in their meta-analysis?

Answer 26

Large body of research to support the effectiveness of typical and atypical antipsychotics.

Question 27

AO3: How many studies did Thornley et al (2003) use in their meta-analysis looking into the effectiveness of typical and atypical antipsychotics?

Answer 27

13 studies

Question 28

AO3: How many participants were investigated by Thornley et al (2003) in their meta-analysis?

Answer 28

A total of 1121 participants

Question 29

AO3: What did Thornley et al (2003) find about Chlorpromazine (typical) against a placebo?

Answer 29

Typical antipsychotic was associated with better overall functioning and reduced symptom severity.

Question 30

AO3: According to Thornley et al’s (2003) meta-analysis, which type of drug was associated with better overall functioning and reduced symptom severity.

Answer 30

Typical antipsychotic

Question 31

AO3: What did Meltzer (2012) conclude about Clozapine (atypical)?

Answer 31

Clozapine (atypical) was more effective than typical antipsychotics and is effective in 30-50% of treatment resistant cases.

Question 32

AO3: Why does drug therapy require little motivation from the patients?

Answer 32

This is because the patient only has to take a tablet in order to reduce the symptoms of schizophrenia, whereas with alternative options like CBT require motivation to attend sessions and challenge irrational thoughts such as hallucinations.

Question 33

A strength of drug therapy as a treatment for SZ, is that typical and atypical antipsychotics require little ______________ from the patient.

Answer 33

Motivation

Question 34

AO3: What can you compare motivation and commitment of drug therapy to? Give an example.

Answer 34

Cognitive Behaviour Therapy

Requires motivation from patients as they have to
attend sessions and engage in them in order to identify and challenge irrational thoughts such as delusions.

Question 35

AO3: In Cognitive Behaviour Therapy patients must attend sessions and engage in them in order to identify and challenge irrational thoughts such as delusions. Why might this be difficult for a person with schizophrenia?

Answer 35

This may be difficult for a person with schizophrenia as they may not have an accurate perception of reality.

Question 36

AO3: What is an example of a side-effect that typical antipsychotics such as chlorpromazine have?

Answer 36

Typical antipsychotics can produce movement side effects such as parkinsonism (Parkinson-like symptoms).

Question 37

AO3: What is an example of a side-effect that atypical antipsychotics have?

Answer 37

Atypical antipsychotics carry the risk of a life-threatening illness, agranulocytosis (reduced white blood cell count)

Question 38

AO3: A weakness of using drug therapy to treat Schizophrenia is that they can cause negative side effects.

What can this be compared to and why?

Answer 38

CBT - this involves a person identifying and challenging irrational thoughts (e.g. delusions) without the use of drugs. This means that there are no negative side effects.

Question 39

Why does CBT have minimal life-threatening side effects?

Answer 39

CBT involves a person identifying and challenging their irrational thoughts (delusions), without the use of drugs so there are no negative and potentially life-threatening side effects.

Question 40

What ethical issues might be associated with the use of antipsychotics?

Answer 40

It is widely believed that antipsychotics have been used in hospital situations to calm patients and make them easier to work with, rather than to benefit the patients (Moncrieff, 2013)