Biological therapies for schizophrenia: drug therapy

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6 Terms

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Drug therapy

Involves the treatment of schizophrenia through the use of antipsychotic medication to reduce symptoms

All antipsychotics work by reducing dopamine transmission - reducing the actions of the neurotransmitter dopamine areas of the brain associated with the symptoms of schizophrenia

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Types of antipsychotics

Typical

Atypical

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Typical antipsychotics

Work as dopamine antagonists: reduce dopamine activity by blocking dopamine receptors at the synapse

  • Bind to dopamine receptors but do not stimulate them, reducing the action of dopamine

  • Initially dopamine levels build up, but then production is reduce

  • This normalises neurotransmission in key areas of the brain, reducing positive symptoms

Side effects: CHLORPROMAZINE

  • dry mouth

  • Lethargy

  • Tardive dyskinesia - uncontrollable muscle movements usually affecting the face

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Atypical antipsychotics

  • Block dopamine receptors, but only temporarily occupy and then rapidly dissociate to allow normal dopamine transmission

  • Also act on other neurotramitters, targeting negative symptoms: serotonin and glutamate

Side effects: CLOZAPINE/RISPERIDONE

  • Cardiovascular problems

  • Arangulocytosis: fatally low levels of neutrophil

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Negative evaluations (3)

Likelihood of side effects ranging from mild/serious/fatal is extremely high

Critics argue if side effects were taken into account a cost-benefit analysis of its advantages would be negative

  • In the USA a large out of court settlement was awarded to a tardive dyskinesia sufferer on the basis of HRA , that no one should be subject to inhumane treatment

  • Widely believed that antipsychotics have been used in hospital situations to make patients calmer and easier to deal with - patients with severe symptoms may not be able to give fully informed consent

Healey 2012 - argued that some results of clinical trials have had their data published multiples times in order to exaggerate the positive effects

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Positive evaluations (2)

Enhance the quality of life for patients as they allow them to live independently of institutional care.

Leucht 2012 - meta-analysis of 65 studies involving 6000 patients with some taken off antipsychotics

12 months: 64% placebo relapsed VS. 27% drugs