Schizophrenia: Drug Therapy - Typical/Atypical antipsychotics Flashcards
What type of drug is the most common treatment for schizophrenia?
Antipsychotic drugs
Is antipsychotic drugs the most or least common treatment for schizophrenia?
Most
What factor should you consider when choosing the right course length of antipsychotics?
Depending on the severity of their psychosis
What are the two types of anti-psychotic drugs?
Typical and atypical
Which type of drugs are used more often and why?
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.
When would an individual use atypical anti-psychotic drugs?
If symptoms do not improve
Name a Typical antipsychotic drug
Chlorpromazine
How do dopamine antagonists work?
They reduce levels of dopamine activity in the brain by binding to the D2 receptors on the post synaptic neurons in the brain.
Explain why Chlorpromazine are dopamine antagonists
Chlorpromazine reduces levels of dopamine activity in the brain
Chlorpromazine works by ___________ to the _____ receptors on _____ synaptic neurons in the brain, reducing the action of____________.
binding
D2
post
Dopamine
Chlorpromazine works by binding to what?
D2 receptors on post synaptic neuron
What happens to dopamine levels when Chlorpromazine binds to the D2 receptors?
Reduces the action of dopamine.
What happens to individuals’ symptoms of schizophrenia when taking Chlorpromazine?
Reduces positive symptoms of schizophrenia such as hallucinations and paranoia.
Name an atypical drug used to treat schizophrenia.
CLOZAPINE
Atypical antipsychotics act upon which neurotransmitter(s) ?
Dopamine and Serotonin.
What type of drugs act upon Dopamine AND Serotonin in the brain?
Atypical antipsychotics e.g. Clozapine
Clozapine also binds to what receptors sites?
D2 dopamine receptor sites
What happens to individuals’ symptoms of schizophrenia when taking Clozapine?
Reduces positive symptoms such as hallucinations.
AND
Reduces negative symptoms of schizophrenia such as a lack of emotions.
Why do atypical drugs like clozapine act as agonists?
Increase levels of serotonin.
Clozapine increases levels of serotonin in the brain. How does this affect symptoms of schizophrenia?
Reduces negative symptoms of schizophrenia such as a lack of emotions as it helps improve mood and reduce depression and anxiety in patients.
Why do Atypical antipsychotics (clozapine) have fewer side effects than typical antipsychotics (chlorpromazine)?
Atypical antipsychotics they have less action on the dopamine system.
Why are typical antipsychotics are used first?
This is because atypical antipsychotics (clozapine) are associated with a life-threatening illness (agranulocytosis).
What is Agranulocytosis?
Agranulocytosis is a blood condition where there are low levels of white blood cells, preventing and individual fighting of disease and illness.
When are atypical antipsychotics (clozapine) used as opposed to typical antipsychotics?
Atypical antipsychotics (clozapine) are only given if typical antipsychotics (chlorpromazine) are not effective or if the patient has severe negative side effects.
AO3: Evidence to support the EFFECTIVENESS of antipsychotics as a treatment of schizophrenia comes from…
Thornley et al. (2003)
AO3: What large body of research did Thornley et al (2003) in their meta-analysis?
Large body of research to support the effectiveness of typical and atypical antipsychotics.
AO3: How many studies did Thornley et al (2003) use in their meta-analysis looking into the effectiveness of typical and atypical antipsychotics?
13 studies
AO3: How many participants were investigated by Thornley et al (2003) in their meta-analysis?
A total of 1121 participants
AO3: What did Thornley et al (2003) find about Chlorpromazine (typical) against a placebo?
Typical antipsychotic was associated with better overall functioning and reduced symptom severity.
AO3: According to Thornley et al’s (2003) meta-analysis, which type of drug was associated with better overall functioning and reduced symptom severity.
Typical antipsychotic
AO3: What did Meltzer (2012) conclude about Clozapine (atypical)?
Clozapine (atypical) was more effective than typical antipsychotics and is effective in 30-50% of treatment resistant cases.
AO3: Why does drug therapy require little motivation from the patients?
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.
A strength of drug therapy as a treatment for SZ, is that typical and atypical antipsychotics require little ______________ from the patient.
Motivation
AO3: What can you compare motivation and commitment of drug therapy to? Give an example.
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.
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?
This may be difficult for a person with schizophrenia as they may not have an accurate perception of reality.
AO3: What is an example of a side-effect that typical antipsychotics such as chlorpromazine have?
Typical antipsychotics can produce movement side effects such as parkinsonism (Parkinson-like symptoms).
AO3: What is an example of a side-effect that atypical antipsychotics have?
Atypical antipsychotics carry the risk of a life-threatening illness, agranulocytosis (reduced white blood cell count)
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?
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.
Why does CBT have minimal life-threatening side effects?
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.
What ethical issues might be associated with the use of antipsychotics?
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)
