Schizophrenia: Drugs

Question 1

AO1

Answer 1

• Drug treatments use psychoactive drugs that change the balance of neurotransmitters in the brain e.g. antipsychotics reduce the availability of dopamine as high levels of dopamine are implicated in schizophrenia
• Psychiatrists will adjust the quantity of a drug so it is tailored to the level needed for that patient
• Administered as syrup, tablet or injection
• The drugs work by blocking dopamine receptors in the brain
• This reduces positive symptoms such as hallucinations
• There are two types of drug typical and atypical, the latter being the more modern treatments
• The drugs are taken on a regular basis to keep the symptoms under control
• It takes about 10 days before the drug starts to show an effect and symptoms reduce
• Psychoactive drugs for treating mental disorders are available on prescription and patients will be monitored to ensure they are responding to the drugs
• There are usually several different drugs for treating the same disorder and it may be necessary to try several different ones until the drug that suits a particular patient best is found

Question 2

+AO3- Emsley (2008)

Answer 2

found 84% of patients on anti-psychotics had atleast 50% reduction in symptoms if they were given early enough

Question 3

+AO3- Kane (1992)

Answer 3

help approximately 80-85% of Schizophrenics

Question 4

+AO3- Hogarty et al (1972)

Answer 4

relapse rates 48% vs 80% without these types of medication

Question 5

+AO3- Meltzer (2004)

Answer 5

Haloperidol gave significant improvements in all aspects compared to placebo (as did 2 of the other drugs)

Question 6

+AO3- Kane et al (1988)

Answer 6

found that out of 200 patients who showed no improvement with the commonly used Haloperidol, 30% responded to Clozapine with an improvement in both positive and negative symptoms.

Question 7

+AO3- Quick and Easy

Answer 7

Drugs act relatively quickly allowing stabilisation of the patient’s condition during the acute phase of illness

Drug treatment allows the patient to return to and function effectively in the community

Question 8

-AO3- Rosa et al (2005)

Answer 8

found only 50% of patients complied with taking their anti-psychotics.

Question 9

-AO3- Leiberman (2005)

Answer 9

Many patients stop taking their medication because of the severe side effects, this effects the effectiveness of this treatment.

Question 10

-AO3- Fenton et al (1997)

Answer 10

Rates of medication non-adherence among schizophrenic patients are approximately 50% within the first year, and up to 74% within the first two years after the onset of disorder. It is estimated that non-adherent schizophrenic patients have a risk of relapse 3.7 times greater than that of adherent patients

Question 11

-AO3- Leucht et al (1999)

Answer 11

Good for ‘positive’ symptoms, however comparative affects on ‘negative’ schizophrenia are marginal

Question 12

-AO3- side effects

Answer 12

some of which are unpleasant leading to poor compliance e.g. Tardive dyskinsea

This means long term compliance with a drug regime is low, estimated compliance is below 50%

Drug treatment is often referred to as a chemical straightjacket/chemical cosh as the side effects can often be debilitating

Question 13

-AO3- effectiveness

Answer 13

Drug treatment is only effective for positive symptoms so those with mainly negative symptoms are not really helped by chemotherapy

Can leave as many as 60% of patients with symptoms that do not respond to treatment

Question 14

-AO3- cannot cure

Answer 14

at best they help the individual manage the disorder

Question 15

-AO3- speed

Answer 15

They are not instantaneous, indeed take longer to act than should be the case if neurotransmitter imbalance is the primary cause of the disorder