SZ: Drug Therapy

Question 1

Atypical antipsychotics

Answer 1

Drugs that carry a lower risk of extrapyramidal side effects, have a beneficial effect on negative symptoms and cognitive impairment, and are suitable for treatment-resistant patients.

Combat positive and negative symptoms.

Question 2

Drug therapy

Answer 2

Treatment of mental disorders such as SZ through the use of antipsychotics to reduce the symptoms of the disorder.

Question 3

Typical antipsychotics

Answer 3

Dopamine antagonists in that they bind to but do not stimulate dopamine receptors and so reduce the symptoms of SZ.

Combat positive symtoms.

Question 4

What is usually recommended as an intital treatment for SZ?

Answer 4

Antipsychotics - after this a combination of medication and psychological therapy.

Question 5

How do typical antipsychotics work?

Answer 5

• Bind to but do not stimulate dopamine receptors, eg. D2 receptors in mesolimbic pathway.
• Blocks their action.
• Reduced stimulation of dopamine system in mesolimbic pathway.
• Eliminates hallucinations and delusions.

Question 6

Give an example of a typical antipsychotic:

Answer 6

Chlorpromazine

Question 7

Give an example of an atypical antipsychotic:

Answer 7

Clozapine

Question 8

What has research is used to explain the negative side effects of using typical antipsychotics?

Answer 8

Kapur (2000)

• Estimated that 60-75% of D2 receptors in mesolimbic pathway must be blocked for drugs to be effective.
• To do this, a similar number of recprots in other areas of the brain must also be blocked, leading to undersirable side effects.

Question 9

The effectiveness of dopamine antagonists in reducing SZ symptoms led to what?

Answer 9

The development of the dopamine hypothesis of SZ.

Question 10

How long does it usually take for typical antipsychotics to be effective?

Answer 10

Hallucinations and delusions = diminish within a few days.

Other symptoms = can take several weeks.

Question 11

How have the problems of typical antipsychotic drugs been addressed?

Answer 11

Through the use of atypical antipsychotics.

Question 12

How are atypical antipsychotic drugs different to typical antipsychotics?

Answer 12

• Rapid dissociation - only temporarily occupy the D2 receptors so normal dopamine transmission can continue.
• Have a stronger affinity for serotonin receptors and a lower affinity for D2 receptors - explains different effects.

Question 13

What is thought to be responsible for the lower levels of extrapyrimidal side effects in atypical antipsychotics?

Answer 13

Their ability to rapidly dissociate.

Question 14

What are the proven effects of typical antipsychotics?

What are the claimed effects?

Answer 14

Proven = reduce positive symptoms

Claimed = none

Question 15

What are the proven effects of atypical antipsychotics?

What are the claimed effects?

Answer 15

Proven = reduce positive symptoms

Claimed = reduce negative symptoms and cognitive impairments.

Question 16

Extrapyramidal side effects

Answer 16

When drugs appear to impact on the extrapyramidal area of the brain, which helps to control motor activity.

Parkinsonian and related symptoms.

Question 17

What are the evaluation points for drug therapy in SZ?

Answer 17

• Extrapyramidal side effects and ethical problems with typical antipsychotics.
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