Biological treatments

What are antipsychotics?

Drugs used to reduce intensity of symptoms, particularly positive symptoms of psychotic conditions

What is

Drugs used to reduce intensity of symptoms, particularly positive symptoms of psychotic conditions

Antipsychotics

What are typical antipsychotics?

First generation

Work as dopamine antagonists (blocking)

What is

First generation

Work as dopamine antagonists (blocking)

Typical antipsychotics

What are atypical antipsychotics?

Second generation

Work on a range of neurotransmitters

What is

Second generation

Work on a range of neurotransmitters

Atypical antipsychotics

3 benefits of drug therapy

-No surgery = less danger

-More ethical + less dehumanising

-Effects are not necessarily permanent

What is

-No surgery = less danger

-More ethical + less dehumanising

-Effects are not necessarily permanent

3 benefits of drug therapies

What is the most common treatment for sz?

Drug therapies

What do sz patients at higher risk of failing to take medication have?

Antipsychotics in form of injections every 2-4 weeks

Who has Antipsychotics in form of injections every 2-4 weeks?

SZ patients at rid of failing to take medication

Antipsychotics can be used short term or long term

True

Depends on severity of illness

Depending on severity of illness, antipsychotics are either taken

short term or long term

Antipsychotics dont cure sz but dampen symptoms so

degree of normal functioning can occur

Name 1 typical antipsychotic

Chlorpromazine

What is Chlorpromazine?

Typical antipsychotic

What form is Chlorpromazine taken in?

Any

(tablet, syrup, injection)

How long has Chlorpromazine been around for?

Since 1950s

What typical antipsychotic has been around since the 1950s?

Chlorpromazine

How does Chlorpromazine work?

Works as a dopamine antagonists

Blocks dopamine synapses in brain to reduce action of neurotransmitters in dopamine system

What is

Works as a dopamine antagonists

Blocks dopamine synapses in brain to reduce action of neurotransmitters in dopamine system

How Chlorpromazine works (typical antipsychotic)

Dosage of Chlorpromazine

Varys based on needs

400mg, 800mg, 1000mg

What is

Varys based on needs

400mg, 800mg, 1000mg

Dosage of Chlorpromazine

Link b/t Chlorpromazine + dopamine hypothesis

Effect normalises neurotransmission in key areas of brain, reducing positive symptoms

What is

Effect normalises neurotransmission in key areas of brain, reducing positive symptoms

Link b/t Chlorpromazine + dopamine hypothesis

Name another use for Chlorpromazine

Sedative to calm people

Usually when first arrive to hospital + v.anxious

What antipsychotic can also be used as a sedative?

Chlorpromazine

Side effects of Chlorpromazine

-Long term use can result in tardive dyskinesia

→ caused by dopamine sensitivity

→ involves involuntary movement of muscles eg: grimacing

-Neuroleptic malignant syndrome

→ believed to caused by blocked dopamine in hypothalamus

→ results in a coma

Which type of antipsychotic has more side effects?

Typical

What is

-Long term use can result in tardive dyskinesia

→ caused by dopamine sensitivity

→ involves involuntary movement of muscles eg: grimacing

-Neuroleptic malignant syndrome

→ believed to caused by blocked dopamine in hypothalamus

→ results in a coma

2 side effects of Chlorpromazine

What causes tardive dyskinesia?

Side effect of Chlorpromazine

Dopamine sensitivity

What causes Neuroleptic malignant syndrome?

Side effect of Chlorpromazine

Blocked dopamine action in hypothalamus

What is tardive dyskinesia?

Involuntary muscle movements such as grimacing

What is neuroleptic malignant syndrome?

Results in coma

Name 2 atypical antipsychotics

Clozapine

Risperidone

What is

Clozapine

Risperidone

2 atypical antipsychotics

Clozapine history

Developed 1960s w/ aim of reducing sz symptoms w/ minimal side effects

Withdrawn temporarily 1970s coz ppl kept dying of blood condition of low whit blood cells

What is

Developed 1960s w/ aim of reducing sz symptoms w/ minimal side effects

Withdrawn temporarily 1970s coz ppl kept dying of blood condition of low whit blood cells

Clozapine history

When is clozapine used?

When other treatments failed

What is clozapine?

Second generation atypical antipsychotic

Daily dosage of clozapine

300-450mg

What is

300-450mg

Daily dose of clozapine

How does clozapine work?

Binds to dopamine receptors in same way chlorpromazine does but also acts on serotonin + glutamate receptors

Believed this helps improve mood + reduce depression

What is

Binds to dopamine receptors in same way chlorpromazine does but also acts on serotonin + glutamate receptors

Believed this helps improve mood + reduce depression

How clozapine works

3 receptors clozapine works on

Dopamine

Serotonin

Glutamate

Who is clozapine often prescribed to due to ability to improve mood + depression?

SZ at risk of suicide

3 side effects of clozapine

-Weight gain

-Muscle tremors

-Diabetes

What is

-Weight gain

-Muscle tremors

-Diabetes

3 side effects of clozapine

Risperidone aim

Antipsychotic with less side effects

Around since 1990s

How does Risperidone work?

Binds to dopamine + serotonin receptors

→binds to dopamine more strongly than clozapine so more effective in smaller does so less side effects

What is

Binds to dopamine + serotonin receptors

→binds to dopamine more strongly than clozapine so more effective in smaller does so less side effects

How Risperidone works

Why might Risperidone have less side effects?

Binds to dopamine receptors more strongly than clozapine does so can be given in smaller doses

2 receptors Risperidone binds to

Dopamine

Serotonin

2 Strengths of antipsychotics

-Typical are at least moderately effective

-Evidence of atypical effectiveness

Strength of antipsychotics - Typical are at least moderately effective

P: Typical are at least moderately effective

E: Researchers reviewed data from 13 trials and found chlorpromazine was associated w/ better functioning + reduced symptom severity comp. to placebo

I: Possible severe side effects (TD, NMS)

C: Shows effectiveness

Strength of antipsychotics - Evidence for effectiveness of atypical

P: Evidence for effectiveness of atypical

E: Researcher concluded atypical more effective than typical and 30-50% more effective in treatment resistant cases

C: Beneficial

2 Weakness of antipsychotics

-Used to calm patients + make them easier for staff to deal with

-Dopamine theory has flaws

Weakness of antipsychotics - Used to calm patients and make them easier for staff to deal with

P: Used to calm patients and make them easier for staff to deal with

E: National Institute for Clinical Excellence recommends short term use of antipsychotics

C: Human rights abuse

Weakness of antipsychotics - Dopamine hypothesis is flawed

P: Dopamine hypothesis is flawed

E: Evidence that some levels of dopamine in brain are too low rather than tok high meaning antipsychotics shouldn’t work

C: Havnt eradicated all side effects so maybe use of antipsychotics for sz not appropriate