Schizophrenia- Drug treatments Flashcards
(25 cards)
How do antipsychotic drugs work?
Reduce transmission of dopamine
What is the purpose of antipsychotics?
To help the person to manage their disorder and overall wellbeing
Difference: Which type of antipsychotic was developed first (1st generation)?
Typical antipsychotics- 1950s (atypical antipsychotics 1980s)
How do typical antipsychotics work?
-They are dopamine anatgonists
-Bind to but do not stimulate dopamine receptors, particularly D2 receptors in the mesolimbic pathway
Which type of symptoms do typical antipsychotics target? Why are they effective in doing this?
-Positive symptoms
-Reduce stimulation
What cause the undesirable side effects of typical antipsychotics?
-They block D2 receptors in other areas of the brain (other than the mesolimbic pathway)
What do atypical antipsychotics target?
Negative symptoms + positive symptoms+ cognitive impairment
How do atypical antipsychotics work?
-Block D2 receptors but only temporally, then rapidly dissociate to allow for normal dopamine transmission
Why do atypical antipsychotics have different effects?
-They have a stronger affinity for serotonin + lower affinity for D2 receptors
Give 4 differences between atypical and typical antipsychotics?
-Typical were developed 1st
-Atypical have a lower risk of extrapyramidal side effects
-Atypical only block D2 receptors temporarily
-Atypical have stronger affinity for serotonin
Give a type of TA
Chlorapromizine
Give a type of AA
Respiridone
How are both types of antipsychotics taken
-Tablets
-Syrup
-Injection
How does dosage of medication usually work? Why is this done?
-Start on lowest dosage and increased as needed
-To look at the severity of the side effects
What are the side effects of TAs (specifically chlorpromazine)?
-Difficulty urinating
-Blurred eyesight
-Weight gain
-Skin sensitive to sunlight
-Drowsiness
What are the side effects of AAs (specifically risperidone)?
-Difficulty moving (muscle stiffness, slow shuffling walk)
- tardive dyskinesia (sensitivity to dopamine)
-Weight gain/ changes in appetite
-Stomach pain/nausea/vomiting
Give some practical and social problems associated with medication for schizophrenia
-Delusions may still be present, may believe that they are being poisoned
-If family dysfunction is an issue (/live alone due to this), there may be nobody to assist them with this
-If they suffer with memory problems they may forget to take it
-Not being motivated/ have enough desire to take it, may feel like a burden
What is an alternative drug treatment to antipsychotics? What does it reduce?
-Canibidiol (CBD) -(regulated production of cannabis by pharmaceutical companies)
-Reduces the negative symptoms
What did pedersens study show?
-100 norwegion canibais (street) users
-The production cannabidiol (medicalisation of cannabis) is not a good idea as the general public think that it is the same as street cannabic and can cure everyday issues people face
Why is street cannabis dangerous?
-Unreliable
-Problems with dosage
What does cannabidiol link to (issues and debates)?
-Social sensitivity as it causes social issues
Give an evaluation point, weakness (Side effects)
-Drugs can be problematic due to the side effects they cuase, which can range from serious to fatal
-Typical antipsychotics are associated with dizziness, agitation,sleepiness, stiff jaw, weight gain and itchy skin
-Long term use can result inn tardive dyskenia
-This is an issue as most paitents will use medication long term as SZ is a lifelong condition
-Atypical antipsychoctics have fewer side effects because of their mechanism of action, but do still have side effects
-The side effects may impact everyday life and may impact everyday functioning more than the disorder itself
-Can cause conflicting symptoms
Give a strength (Research support)
-Thornley et al reviewed studies comparing the effects of chlorpromazine and a placebo
-Data from 13 trials of 1121 participants found that chlorpromazine was associated with better overall functioning and reduced symptom severity
-Leucht et al carried out a meta-analysis of 65 studies involving nearly 6000 participants
-All had been given antipsychotics and given a placebo instead
-Within 12 months 64% of those who had been placed on the placebo relapsed, compared to 27% of those who remained on the antipsychotic
drug
-This shows that it is effective and can be beneficial for a lot of people and increase their quality of life
-However, it may be more effective if used in conjunction with another form of treatment
-
Give a weakness (consequences)
-Critics argue if the side effects, deaths and psychological consequences were taken into account, a cost- benefit analysis of its advantages would probably be negative
-In the USA, a large out of court settlment was awarded to a traditive dyskenia sufferer on the basis of the human rights act that no one should be subjected to inhumane, degrading treatment or punishment
-Additionally it is widely belived that antipsychoctics have been used in hospitail situation to make paitents calmer and easier to deal with, rather than for the benefit for the paitent themselves- known as chemical cosh
-Futhermore paitents with severe symptoms (such as hallucinations or delusions) may not be able to give fully informed consent
-This shows that using drug treatments in some cases may be unethical
