Sz Bio Treatment - Anti-Psychotics Flashcards
What is an anti-psychotic treatment? (4 points)
Medication that alters brain chemistry to stabilise neurotransmitter imbalances
Functions by blocking dopamine receptors to reduce dopamine activity
Administered in tablet or syrup form
If patients forget or refuse to take it, it can be injected into the bloodstream and restraint can be used
What are typical 1st-generation anti-psychotics? (3 points)
Established in the 1950’s as neuroleptic drugs which functions at the neuronal level
Haloperidol and Chlorpromazine are D2 antagonists (inhibitors) - they decrease dopamine activity
When dopamine levels are decreased in the mesolimbic pathway of the brain, this can help to reduce positive symptoms of Sz like auditory hallucinations
What are atypical 2nd generation antipsychotics? (3 points)
Designed to have fewer side effects
Clozapine:
+ High affinity as a serotonin 5HT2A antagonist
+ Helps to alleviate the positive symptoms of Sz
Aripiprazole:
Acts as a partial D2 dopamine agonist and serotonin 5HT2A antagonist
What are the 2 advantages of typical 1st generation anti-psychotics?
More ethical for patients - led to a shift from invasive procedures like lobotomy and ECT used to sedate mental health patients to drug therapy
Allows patients to be integrated back into their homes and societies rather than being sent to far away mental health asylums
What are the 5 side effects of typical 1st generation anti-psychotics?
Tardive dyskinesia
Apathy
Low libido
Weight gain
Extra-pyramidal side effects (movement disorders)
What are the 2 advantages of 2nd generation antipsychotics?
Stronger medicinal effect than 1st generation - normally used as an alternative if other anti-psychotics do not work
Does not affect the dopamine systems which control movement - does not cause extrapyramidal side effects (movement disorders) or tardive dyskinesia
What are the 3 disadvantages of 2nd generation antipsychotics?
Can affect the bone marrow by decreasing white blood cell count - decreases the immune system functioning and makes patients vulnerable to infections
Side effects:
+ Weight gain
+ Severe constipation
+ Increased heartbeat
+ Pooling of saliva
Weekly blood test for the first 18 weeks, then every 2 weeks to monitor blood cell counts
What are the 2 supporting and challenging studies of biological treatments for Sz?
FGA:
Supported by: Meltzer et al (2004)
SGA:
Supported by: Emsley (2008)
Challenged by: Hartling et al (2012)
Overall:
Rosa et al (2005)
Morrison et al. (2014) - alternate treatment (CBT)
How does Meltzer et al (2004) support the use of FGAs to treat Sz? (3 points)
Sz patients were given either haloperidol or a placebo for 6 weeks
Results showed significant improvements in all areas of functioning compared to a placebo
This suggests FGAs have efficacy
How does Emsley (2008) support the use of SGAs to treat Sz? (2 points)
Newly diagnosed Sz patients were given the SGA risperidone
78% of them had at least a 50% reduction in symptoms of psychosis
How does Hartling et al (2012) challenge the use of SGAs to treat Sz? (2 points)
Meta-analysis of 114 studies comparing the efficacy of FGAs and SGAs found few differences in the core symptoms
Inconclusive benefits of SGAs being better than FGAs
How does Rosa et al (2005) challenge biological treatments for Sz? (2 points)
An average of only 44% of patients complied with taking anti-psychotic drugs
Non-adherence occurred because patients:
‘Lacked knowledge about their disorder’
‘Fear of side effects’
‘Denied drugs were effective’
How is CBT as an alternative treatment for Sz other than anti-psychotics? (2 points)
CBT - cognitive therapy which focuses on maladaptive thinking and how thoughts can be readjusted through counselling
Morrison et al. (2014):
Cognitive therapy was just as effective at reducing the symptoms of psychosis as drug therapy and had lower dropout rates
