SZ- MOM Antipsychotic drugs

Question 1

How can antipsychotic drugs be taken?

Answer 1

Tablets, syrups or injected

Question 2

What is the first generation of antipsychotics?

Answer 2

Typical (conventional drugs)
Introduced in 1950’s
Dopamine antagonist
Targeting positive symptoms

Question 3

What is the second generation of antipsychotics?

Answer 3

Atypical drugs
Developed in 1970’s
Developed to reduce positive and negative symptoms
-Work on multiple neurotransmitters

Question 4

General information regarding conventional antipsychotic drug?

Answer 4

Been around since 1950s
Taken orally injected or liquid
Not commonly used today

Question 5

What is a conventional drug?

Answer 5

Chlorpromazine

Question 6

Conventional- How does chlorpromazine work?

Answer 6

Acts of an antagonist by blocking dopamine receptors within the brain reducing action of neurotransmitters in the mesolimbic pathway
There becomes a build up but then this reduces

Question 7

Conventional- Chlorpromazine what effects does this have on the body?

Answer 7

Positive symptoms like hallucination
Maximum of 400-800 mg

Question 8

Conventional- Chlorpromazine side effects?

Answer 8

Sedative
Tardiv dyskinesia
Agitation
Weight gain
Itchy skin

Question 9

General information regarding atypical?

Answer 9

Developed in 1990s/1970’s
More used today

Question 10

Atypical- 2 examples?

Answer 10

Clozapine
Risperidone

Question 11

Atypical- Clozapine how do they work?

Answer 11

Temporarily bind to dopamine receptors by reducing it in the brain
Also works on serotonin and glutamate receptors in order to reduce depression and anxiety symptoms
-300/400 mg

Question 12

Atypical- Clozapine side effects?

Answer 12

Reduces anxiety and depression
-Lacks white blood cells so can cause weak immune system
-Regular blood tests
Blurred vision.
confusion.
constipation.
dizziness

Question 13

Atypical- Risperidone how does this work?

Answer 13

Developed in 1990’s can be in tablet, syrup or injected
Binds to dopamine and serotonin receptors temporarily
Very strong so take less with the same effect
Positive and negative symptom

Question 14

Atypical- Risperidone side effects?

Answer 14

Erectile dysfunction
Constipation
Blurred vision

Question 15

Evaluation- Cole et al reaserch?

Answer 15

Psychiatry can treat mental illness the same way it can treat physical
-75% of study given conventional had improved and none got worse where as 25% of placebo improved and 48% got worse

Question 16

Evaluation- why is cole et als research a strength?

Answer 16

Because its supporting research
Its revolutionary and useful when seeking to understand how anti p can be used to modify SZ

Question 17

How does Noll et al counter cole et als research?

Answer 17

1/3 of the patients didn’t respond to conventional antipsychotics

Question 18

Evaluation- atypical more effective than conventional: who researched this?

Answer 18

Ravanic et al

Question 19

Evaluation- atypical more effective than conventional: Ravanic et al?

Answer 19

Compared effectiveness of Clozapine and Chlopromisie and haloperidol in 325 individuals with SZ
Over 5 yrs there were differences in psychometric scores measuring SZ symptoms favoring clozapine, few average effects due to 0.9 averse events
-Halpodril 27 and chlorpromazine 32
Atypical more ideal

Question 20

Evaluation- atypical more effective than conventional: Ravanic et al counter argument?

Answer 20

Not a ‘one size fits all’ approach
Not all patients find atypical anti psychotics to be more effective at reducing SZ symptoms than conventional

Question 21

Evaluation- effectiveness non compliance: what is non compliance in SZ patients?

Answer 21

Issue in those with chronic SZ as many individuals lack the necessary insight into own conditions, so don’t have a problem so don’t take medication

Question 22

Evaluation- effectiveness non compliance: Rettenbacher et al research?

Answer 22

Full compliance in only 54.2% of individuals with SZ partially compliance of 8.3% with SZ and non compliance in 37.5 with SZ
Real world antipsychotics may not be as effective as they have been in closely controlled clinical studies above

Question 23

Ethical- side effects?

Answer 23

SZ patients can experience Tardive Dyskinesia and Parkinsonism
TD is involuntary muscle movements like tics that’s irreversible
Parkinsonism- shaking (tremors), slow movements and stiffness.
-When antipsychotics are used on SZ patients who are experiencing an acute episode of the disorders so cant consider valid consent
-BUT are the side effects outweigh SZ

Question 24

Ethical- chemical straight jacket?

Answer 24

This is when we chemically sedate someone that may as well be in a straight jacket due to their controlled and zombie nature
-Have this instead of therapeutic value and curing symptom
-So unethical as they raise the question of what purpose they serve

Question 25

Ethical- chemical straight jacket researcher?

Answer 25

Szasz

Question 26

Ethical- chemical straight jacket Szasz?

Answer 26

This method of social control to keep individuals conformist

Question 27

Ethical- chemical straight jacket counter argument?

Answer 27

Antipsychotics are necessary to keep the SZ patient from harming themselves and others

Question 28

Social implication- strength?

Answer 28

They pave a pathway for new revolution of care in the community

Question 29

Social implication evidence?

Answer 29

Lawrie

Question 30

Social implication Lawrie?

Answer 30

AP drugs revolutionised the core of SZ changing it from an inaccurate condition which required institutionalised to one that treated in the community with potential over independent living and recording
-Links to social revolution beneficial both for patient because they can can lead to more normal lives benefiting society due to cost of being in hospital
Less people in hospital means more to economy