SZ- Biological Therapies Flashcards
What is the most common treatment for schizophrenia?
- Antipsychotic drugs (drugs used to reduce the intensity of the symptoms) are the most common treatment for schizophrenia.
- They involve modifying/interfering with the action of neurotransmitters, in order to increase (agonists) or decrease (antagonists) their activity.
- Medication can be taken as pills, syrups or injections, and may be taken over a short or long-term.
Which two main types can antipsychotic drugs be divided into?
1) Typical (traditional/first generation) antipsychotics - used since 1950s
2) Atypical (second generation) antipsychotics - used since 1970s
What is an example of a typical antipsychotic?
Chlorpromazine.
How do typical antipsychotics work?
- They act as dopamine antagonists, attempting to reduce dopamine activity.
- They block dopamine receptors on post-synaptic neurons, meaning that less dopamine is transmitted across the synapse.
- This has the effect of reducing dopamine production, and reduces positive symptoms such as hallucinations. - Drugs such as Chlorpromazine also have a sedative effect, meaning that they calm patients down and reduce anxiety.
What is an example of an atypical antipsychotic?
Clozapine
How does Clozapine work?
- Clozapine is used when other drugs have failed, due to the risk of agranulocytosis (a potentially fatal blood condition).
- Clozapine acts in a similar way to Chlorpromazine, but also acts on serotonin and glutamate receptors.
- The effect of this is, as well as reducing positive symptoms, the reduction of depression and anxiety, and the enhancement of mood.
- It is therefore prescribed when the patient is at risk of suicide.
What is another atypical antipsychotic?
- Risperidone is another atypical antipsychotic, and is designed to be as effective as Clozapine without the risky side-effects.
- It binds to dopamine receptors more strongly than Clozapine, and there is some evidence that it produces fewer side-effects.
Evaluate drug therapy in treating schizophrenia. (STRENGTHS)
1) RESEARCH EVIDENCE TO SUPPORT TYPICAL ANTIPSYCHOTICS
- Thornley et al (2003) found in a meta-analysis that Chlorpromazine was associated with better functioning and reduced symptom severity than placebos, supporting that the drug does have a positive effect on schizophrenia patients.
2) RESEARCH EVIDENCE TO SUPPORT ATYPICAL ANTIPSYCHOTICS
- Melzer (2012) concluded that Clozapine is effective in 30-50% of cases where other drugs have failed, supporting its use in schizophrenia treatment.
3) Offering drugs can lead to an enhanced quality of life as patients are given independence - Positive impact on the economy as patients can return to work and no longer need to be provided with institutional care. Patients can control their symptoms and calm them down which is also useful for safety of the individual and others (for example: if they are aggressive they could get violent with others and cause harm)
Evaluate drug therapy in treating schizophrenia.
LIMITATIONS
1) SEVERE SIDE-EFFECTS
- For example, some patients on typical antipsychotics develop tardive dyskinesia- a condition where there are uncontrollable facial tics.
- Even after stopping the use of the drug, this condition can persist. Reduced dosage seems to reduce side effects but the effectiveness of the drug reduces too.The severity of the side-effects is a weakness as patients will be reluctant to take them, or may even die as a result of the effect, leading to high drop out rates.
2) High drop out rates due to people forgetting to take them/effects of side effects.
3) Ethical issues - Antipsychotics have been used in hospitals to calm patients and make them easier for staff to work with rather than for the patients’ benefit - Can lead to the abuse of the Human Rights Act
4) do not “cure” schizophrenia, rather they dampen symptoms down so that patients can live fairly normal lives in the community
