Schizophrenia: Methods of Modification - ANTIPSYCHOTIC MEDICATION

Question 1

How did schizophrenia used to be treated in the 1950s?

Answer 1

• psychosurgery
• electroconvulsive shock therapy
• institutionalisation

Question 2

What were the earliest types of antipsychotic drugs?

Answer 2

phenothiazines

Question 3

How do phenothiazines work?

Answer 3

• sedating the individual
• reducing symptoms of schizophrenia (eg delusions and hallucinations)
• do this by binding to dopamine receptors and blocking the build-up or dopamine

Question 4

What two types of antipsychotic drugs to the majority of them fall into?

Answer 4

• conventional ‘typical’ antipsychotics
• atypical antipsychotics

Question 5

What is the name of a conventional antipsychotic?

Answer 5

chloropromazine

Question 6

What is chlorpromazine?

Answer 6

a dopamine antagonist (reduces the action of the neurotransmitter dopamine)

Question 7

How do dopamine antagonists work?

Answer 7

by blocking dopamine receptors in the brain, which reduces activity in the post-synaptic neuron

Question 8

What does chlorpromazine normalise?
Specifically?

Answer 8

neurotransmission in key areas of the brain - specifically the MESOLIMBIC PATHWAY

Question 9

What effects does chlorpromazine have on the patient?

Answer 9

• reduces positive symptoms such as hallucinations
• has a sedative effect which has a calming effect

Question 10

Why isn’t a sedative effect affective?

Answer 10

• just masks the symptoms, doesn’t treat them
• like a chemical straight jacket

Question 11

How do atypical antipsychotics work?

Answer 11

• bind to dopamine receptors
• don’t permanently block the dopamine action, but temporarily bind to receptors then rapidly dissociate to allow normal dopamine transmission

Question 12

What do atypical antispsychotics aim to do?

Answer 12

aim to reduce both positive and negative symptoms of schizophrenia

Question 13

What are 2 types of atypical antipsychotics?

Answer 13

• clozapine
• risperidone

Question 14

What does clozapine target?

Answer 14

it is a dopamine antagonist but also targets serotonin and glutamate
- serotonin -> mood, anxiety etc.
- glutamate -> memory creation, bodily movement, thought processes

Question 15

What does clozapine reduce and improve?

Answer 15

• reduces positive symptoms such as hallucinations
• improves mood, reduces anxiety, reduces depression, therefore treating some negative symptoms as well as the positive

Question 16

How many people who have schizophrenia attempt suicide?

Answer 16

30-50%

Question 17

Why was risperidone developed?

Answer 17

to produce a drug as effective in treating both positive and negative symptoms as clozapine, but without serious side effects

Question 18

How does risperidone work?

Answer 18

binds to dopamine receptors much more strongly than clozapine
- is therefore effective in smaller doses

Question 19

How was risperidone ranked in terms of effectiveness in a 2013 study?

Answer 19

• compared 15 antipsychotic drugs in treating schizophrenia
• was ranked 4th in terms of effectiveness but 36% less effective than clozapine