biological therapy (not done)

Key terms

Antipsychotics — drugs used to reduce the intensity of symptoms, in particular positive symptoms

Typical antipsychotics — the first generation of drugs for schizophrenia and other psychotic disorders. They work as dopamine antagonists and include chlorpromazine

Atypical antipsychotics — drugs for schizophrenia, developed after typical antipsychotics. Typically target a range of neurotransmitters such as dopamine and serotonin (e.g clozapine and risperidone)

Drug therapy

  • most common treatment is antipsychotics

  • May be required in the short term or long term, depending on if the person has a reoccurrence of schizophrenia when they stop taking the drugs

  • Divided into typical and atypical

Typical antipsychotics

  • the first generation, include chlorpromazine which can be taken as tablets, syrup or by injection

  • For most, the dosage gradually increases to a max of 400-800g

  • Dopamine antagonists — these drugs act as antagonists in the dopamine system, so they reduce the action of a neurotransmitter. Blocking receptors in the synapses of the brain. Initially chlorpromazine causes dopamine levels to build up, but then its production is reduced. This reduces hallucinations

  • Sedation effect — effects the histamine receptors, so calms individuals

Atypical antipsychotics

  • developed after typical antipsychotics

  • Aims was to maintain the effectiveness of drugs while minimising side effects

  • Range of atypical antipsychotics and they do not all work the same

  • Clozapine — was trialed and then withdrawn following the deaths of some patients from a blood condition called agranulocytosis. Clozapine is now used today as a treatment when other treatments have failed because it is more effective, the patients have to have regular blood tests. Due to its potentially fatal side effects, it is not available as an injection. Daily dosage is typically 300-450mg a day. It binds to dopamine receptors and acts on serotonin + glutamate receptors. This improves mood and reduces depression + anxiety. Prescribed when the patient has a high risk of suicide (as 30-50% of people with schizophrenia attempt at some point)

  • Risperidone — more recently developed. Attempt to produce a drug as effective as clozapine but without the side effects. It can be taken as a tablet, syrup or injection that lasts around two weeks. Small dose is initially given, then builds up to a typical daily dose of 4-8mg, max of 12mg. Believed to bind to dopamine and serotonin receptors, it binds more strongly to dopamine so is more effective in much smaller doses. Evidence shows fewer side effects