Outline and evaluate drug therapies in the treatment of schizophrenia. 16 marks

Question 1

Overview of Antipsychotic Medication:

• How does it work?
• How does it help?
• What is it usally recommened as?
• What are the two things that clinicans tend to use.

Answer 1

• All medication work by reducing dopaminergic transmission.
• Helps the person with the disorder function better in life
• Usually recommended as the initial treatment for the symptoms of SZ.
• Which clinicians tend to use a combination of medication and psychological therapy to manage the disorder.

Question 2

Use of Typical Antipsychotics:
(Traditional/conventional/First generation)

Reduce effects of what hormone.

Bind.. but do not..

Answer 2

• Used to reduce the effects of dopamine and so reduce symptoms of SZ.
• Bind to but do not stimulate dopamine receptors thus blocking their action.

Question 3

Examples of Typical Antipsychotic

Answer 3

Chlorpromazine

Question 4

Use of Atypical Antipsychotics:
(Newer/second generation)

2 points

Block
Dissociate
Allowing

Answer 4

• Used to treat positive and negative synptoms

- Block dopamine receptors, rapidly dissociate from them, allowing normal dopamine transmission.

Question 5

The drug Typical antipsychotic drugs significantly reduces…

Answer 5

Postive symptoms

Question 6

The drug Ayptical antipsychotics significantly reduces..

Answer 6

Both positive and negative symptoms of SZ.

Question 7

One side of effect of Typical antipsychotic drugs is..

2 Things

Answer 7

• Can cause movement problems

- Extrapyramidial effects such as tardive dyskinesia (similar to parkinsons - shaking)

Question 8

One side of Aytpical drugs antipsychotics

Answer 8

Weight gain.

Question 9

Who is Aytpical antipsychotics suitable for?

Answer 9

Treatment-resistant paitents.

Question 10

Strength of Atypical antipsychotic Medication - extrapyramidal effects
AO3

Less likely to…
Olzapine
Quetiapine

Answer 10

• Particulary new developed drugs such as olzapine and quetiapine are less likely to produce extrapyramidal effects
  L : As a result, paitents are more likely to continue with their medication, which in turn means they are more likely to see a reduction in their symptoms

Question 11

Strengths of Antipsychotic
Leucht et al (2012)
Antipsychotics and placebos

Answer 11

• Meta analysis used paitents taken of their antipsychotic mediation and given a placebo instead and aitents who remained on their regular antipsychotic.
• Within 12 months, 64% of the placebo group had relapsed compared to 27% of those who stayed on the antipsychotic drugs.

L: Demonstrates the superiotity of antipsychotic drugs compared to placebo in preventing relapse.

Question 12

Limitation of antipsychotics drugs overall
Motivational deficts Ross and Read (2004)
AO3

TRIGGER WORDS:
Reinforces
Prevents
Why does this reduce their motivation?
Possible solutions 
Alleviate..

Answer 12

• Argued that when people are prescribed with antipsychotics medication, in reinforces the view that their is and issue with them.
• Prevents the individual from thinking about possible stressors that might contribute to their condition.
• Therefore reduces their motivation to look for possible solutions that might alleviate these stressors and reduce their suffering.

Question 13

Read (2005) Conclusion (Motivational deficts)

Human misery is…

Best solutions are..
Rather than …. or …

Answer 13

Largerly inflicted by other people the best solutions are usually human - rather than chemical or electrical - interventions

Question 14

Limitation of Typical antipsychotics - Ethical problems
Chari et al, 2002, cited in Ross and read, 2004)
AO3

Answer 14

P: The problems associated with typical antipsychotic medication raise significal ethical issues relating to their use.

• In the US lare out-of-court settlement was awarded wto a tardive dyskinesia suffer on the basis of Article 3 of the Human act 1988.
• States that no one shall be subjected to in inhuman or degrading treatment or punishment

L: Suggests that the side effects and other consequences were taen into account, a cost-benefit analysis of typical antipsychotics would probably be negative

Question 15

Limitation of typical antipsychotics 2
AO3

Movement

Can cause extrapyramidal symptoms such as..

Answer 15

Typical antipsychotic drugs an cause movement problems.

• Most common are those which resemble parkinson’s disease
• More than half of paitents taking typical antipsychotics experience these symptoms.

Question 16

Thornley et al. (2003)

AO3 Typical Antipsychotics

• Comparing the effects of … to …
• Data from how many trails with a totall of how many p’s? showed what? associated with better…
• Data from how many trails with a total of how many p’s showed Relapse rate..

Answer 16

Reviewed studies comparing the effects of chlorpromazine to control conditons in which paitents recieved a placebo.

• From 13 trials with a total of 1121 p’s showed that chloropromazine was associated with better overall functioning and reduced symptom severity.
• 3 trails with a total of 512 P’s showed that relapse rate was also lower when chlorpromazine was taken.

Question 17

Thornley et al. (2003)

What did data from 13 trails with a total of 1121 P’s show?

Overall
Reduced

Answer 17

That chlorproazine was associated with better overall functioning and reduced symptom severity.

Question 18

Thornley et al. (2003)

What did data from 3 trails with a total of 512 P’s show?

Answer 18

That relapse rate was also lower when chlorpromazine was taken.

Question 19

What AO3 evaluation are you using?

Answer 19

Strengths
Aytpical drugs - Extrapyrimidal effect. Olzapine and Quetiapine
Crossley et al 2010 - Effectiveness of Aytpical antipsychotics

Limitations
Motivational deficts
Ross and Read (2004)
Typical antipsychotics limitations - Can cause extrapyramidal symptoms