Schizophrenia - Drug treatments Flashcards
What are anti-psychotics?
- Antipsychotics, also known as neuroleptics are medications that are used to control psychosis, such as delusions and hallucinations
- They work by interfering with neurotransmitter systems
- They are taken in pill form or injected
What are typical anti-psychotics?
-Typical anti-psychotics are the first generation of drugs used in drug therapy since the 1950’s. They are less popular now due to the severe side effects and because they only treat the positive symptoms
What is an example of a typical antipsychotic?
Chlorpromazine
How do typical anti-psychotics work to treat the positive symptoms of schizophrenia?
- The drugs work as dopamine antagonists, they reduce dopamine activity by blocking dopamine receptors at the synapse
- This calms the dopamine system in the brain, reducing positive symptoms such as hallucinations and delusions. The drugs can also have a general sedative effect as well
- The side effects include: A dry mouth, constipation, lethargy, confusion and tardive dyskinesia, uncontrollable muscle movements usually affecting the face
What are atypical anti-psychotics?
-Atypical anti-psychotics are the second generation of drugs used in drug therapy since the 1970’s. Atypical anti-psychotics started to be used in the 1970’s to avoid the more severe side effects of typical anti-psychotics
What is an example of an atypical anti-psychotic?
Clozapine
How do atypical anti-psychotics work to treat the positive and negative symptoms of schizophrenia?
- Atypical anti-psychotics work by blocking dopamine receptors in the synapse but also by acting on other neurotransmitters (For example: Acetylcholine, glutamate and serotonin)
- This allows the atypical anti-psychotics to also treat the negative symptoms of schizophrenia such as avolition
- The side effects include: Weight gain and cardiovascular problems. However atypical anti-psychotics are less likely to cause involuntary movement side effects
How did Leucht’s meta-analysis support the use of drug therapy for treating the symptoms of schizophrenia?
- Leucht conducted a meta-analysis which reviewed 212 studies on the effectiveness of antipsychotic drug treatments that work via stabilising the levels of dopamine
- Treatment of symptoms with the drugs were found to be much more effective than placebos
- This suggests that treatments that target the dopamine system are effective in reducing the symptoms of schizophrenia
How did Bagnall’s meta-analysis support the use of drug therapy for treating the symptoms of schizophrenia?
- Bagnall conducted a meta-analysis which reviewed 232 studies to compare the effectiveness of a range of atypical and typical anti-psychotics
- It was found that atypical drugs were more effective than typical antipsychotics in treating overall symptoms, resulting in fewer movement disorder side-effects and fewer people left the drug treatments early
- Overall clozapine was found to be the most effective in reducing negative symptoms and treating people who were resistant to other drugs
- This research suggests that anti-psychotics are an effective treatment plan, especially those that focus on more neurotransmitters than dopamine
- Therefore, this suggests that the development of atypical drugs has improved the treatment of people with schizophrenia
- As this study showed the effectiveness of atypical anti-psychotics was much higher than typical antipsychotics it could cast doubt on the dopamine hypothesis of schizophrenia as antipsychotics act on a range of neurotransmitters
How does research done by Tarrier suggest that drug therapy alone is not the most effective way to treat the symptoms of schizophrenia?
- Tarrier conducted an experiment to test the effectiveness of drug treatment plans and CBT
- Tarrier placed patients randomly into routine care (Using antipsychotics) or routine care and CBT
- Patients in the combined treatment had a significant improvement in the severity and number of positive symptoms as well as fewer days in hospital receiving care
- This suggests that drug therapy alone is not the most effective treatment plan and an interactionist approach to treating schizophrenia with routine care along side CBT is a better option
How has the development of antipsychotics effected the economy?
- Reducing the symptoms of schizophrenia in patients has allowed them to return to the workplace and directly contribute to the economy
- Drugs are also a much cheaper treatment than working with a trained therapist, this saves health services money
- Drugs have also allowed people to be treated in the community, this saves the expense of treating people full time in institutions
What is a weakness of the use of drug therapy to treat the symptoms of schizophrenia?
- Drug therapies could be criticised as they may only be suppressing the symptoms of schizophrenia instead of treating the true cause of schizophrenia as symptoms can return quickly when the drug therapy stops
- Also many studies look at the short term affect of drugs rather than the long term effects, so there is also a lack of evidence showing the long term benefits of medication
What is a strength of using drug treatment to treat the symptoms of schizophrenia?
- The use of drug treatments has resulted in the end of long term institutionalisation in mental health hospitals
- This could mean that patients perhaps have an enhanced quality of life with people living with their families and additional independence
What is an ethical issue of using drug therapy to treat the symptoms of schizophrenia?
- Drugs are often prescribed/given by force to people with severe symptoms
- There are ethical issues regarding informed consent, especially considering the severe side effects which can be developed along side taking the antipsychotics
What is a weakness of using drug therapy to treat the symptoms of schizophrenia?
- Both types of drugs have side effects, due to the severity of the side effects two thirds of people stop the treatment before their course is over often to avoid the side effects
- This results in the symptoms returning and a “Revolving door” of people returning to treatment
- This may suggest that drug therapy is not effective due to the high drop out rate
