Solution 1) Antipsychotic Drugs

Question 1

What are A-P drugs aimed at?

Answer 1

Blocking dopamine receptors.

Question 2

Why?

Answer 2

Used to treat positive symptoms.
Severe side effects - cramps, dizziness and blurred vision.
Reduces dopamine activity.

Question 3

How do A-P drugs work?

Answer 3

Works by blocking dopamine receptors - reduces dopamine activity.
Blocks mesolimbic pathways.

Question 4

What are the 2 main types of A-P drugs?

Answer 4

Typical (conventional) - Chlorpromazine.

Atypical (2nd generation) - Clozapine.

Question 5

Which are used to treat positive symptoms?

Answer 5

Typical.

Question 6

What are positive symptoms?

Answer 6

Hallucinations, delusions and disordered thinking.

Question 7

What are the side effects?

Answer 7

Cramps, dizziness and blurred vision.

Question 8

What can atypical drugs treat?

Answer 8

Both positive and negative symptoms.

Question 9

Cole et al.

Answer 9

+ One of the earliest pieces of research.
+ Focuses on 1st generation drugs.
+ Pro antipsychotic drugs.
+ Drugs did not worsen.

Question 10

Ravanic et al.

Answer 10

+ Atypical more effective than typical.

+ More effective in dealing with biological causes.

Question 11

Rettenbacker

Answer 11

+ Found drugs effective for schizophrenia.
- Problem with people with schizophrenia is that they are non-compliant. 37.5% of schizophrenic people don’t regularly take medication.

Question 12

A controversial view?

Answer 12

• Chemical straight jacket - drugs only control the patient, they don’t solve schizophrenia.

Question 13

Stephen Lawrie

Answer 13

+ Very pro-new A-P drugs.
+ “Revolutionised the care of schizophrenia.”
+ Allowed people with schizophrenia to move out of industries and into the community.

Question 14

Jan Tiihonen et al.

Answer 14

• Agrees schizophrenic people are non-compliant - a lot of aggression and violence.
• A-P drugs not a cure just controls the issue.
• When a patient stops taking the drugs, the symptoms return in 80% of cases - backed by Lewis et al.

Question 15

Beng - Choon - Ho

Answer 15

+ Drugs control issue.

- In the long run it erodes brain tissue - backed by Lewis et al.

Question 16

Additional Research/Development

Answer 16

• A-P drugs only effective in 75% of cases.

- Ineffective in negative cases.

Question 17

Awad and Voruganti

Answer 17

+ Atypical effective in 85% of patients.

Question 18

Leucht et al.

Answer 18

• Challenges figure of 85% success rate.

Question 19

NCISH

Answer 19

National Confidential Enquiry into Suicide and Homicide

• 29% of all homicides in 2003-13 were committed by those with schizophrenia.
• 29% non-compliant - did not take regular medication.

Question 20

Gilbert et al.

Answer 20

• 53% of patients relapsed within 10 months of drugs being withdrawn.
• 16% relapsed while continuing medication.

Question 21

Harrow

Answer 21

• 20-year longitudinal study.

- Other than first few years, A-P drugs did not reduce frequency of psychotic episodes.

Question 22

Seeman

Answer 22

• Long term medication leads to development of super-sensitivity to dopamine.
• Making some more vulnerable to relapse.

Question 23

Ethical Implications

Answer 23

• Between 20-25% of schizophrenics on A-P suffer from tremors/involuntary movements.
• Clozapine can affect bone marrow or reduce white blood cells or reduce immunity.
  + A-P drugs can help symptoms of schizophrenia and is the most effective treatment.

Question 24

Social Implications

Answer 24

+ A-P relieve symptoms.
+ Reduce the need for hospitalisation and reintegrate people into society.
- Relapses are common.
- Direct costs - hospitalisation and medication.
- Indirect costs - effects of schizophrenic family member.