15. Treatment of Schizophrenia Flashcards
What are the treatments of schizophrenia?
- Hospitalization in state hospitals
- Medical treatments prior to antipsychotic meds (hydrotherapy, insulin coma therapy, lobotomy, electroconvulsive therapy)
- Antipsychotic meds
- Comprehensive treatment on multiple levels
What is the mechanism of older antipsychotic drugs?
They all work by blocking D2 dopamine receptors and improve positive symptoms of schizophrenia
What are examples of older antipsychotic drugs?
- Thorazine
- Prolixin
- Haldol
What are the side effects of older antipsychotic drugs?
- Stiffness of posture and tremors (Parkinson’s like symptoms)
- Shuffling gait
- Stiffening of neck and jaw
- Mask-like face
- Decreased spontaneity
- Restlessness
- Dry mouth, blurred vision
- Impaired sexual functioning
- Sedation
- Weight gain
- Tardive Dyskinesia
What is Tardive Dyskinesia?
- Involuntary movements of tongue and mouth
- Often irreversible
What are the risk factors for developing Tardive Dyskinesia?
- Female
- Genetics
- Elderly
- Hx of head injury
- Hx of drug use
- Length of time drug was taken
- Dosage
What is the mechanism of newer antipsychotic drugs?
- Work on dopamine circuit D1, D2, and D4
- Work on serotonin system and other NTs
- Action is more specific
What are the advantages of newer antipsychotic drugs as opposed to the older ones?
- Generally fewer side effects = no tardive dyskinesia, fewer Parkinson’s symptoms
- Treat both positive and negative symptoms
- Some mood stabilizing properties (especially Zeprexa and Abilify)
What are the side effects of newer antipsychotic drugs? Which drug(s) is each side effect associated with?
- Agranulocytosis (Clozaril)
- Sedation (Clozaril, Zeprexa, Seroquel)
- Weigh gain (all but mostly Clozaril and Zeprexa)
- Higher risk for diabetes (Zeprexa)
Describe comprehensive treatment on multiple levels.
- Antipsychotic meds
- Counseling/case management
- Social skill & communication training; socialization opportunities
- Life skill training
- Supportive housing
- Occupational therapy & supportive work
- Family counseling
Describe the family counseling aspect of comprehensive treatment on multiple levels.
- Educate family members about schizophrenia
- Reduce self-blame in family members
- Reduce expressed emotion in family members to prevent relapse (avoid criticism, hostility, emotional over-involvement)
List the new antipsychotics.
- Clorazil
- Zeprexa
- Risperdol
- Seroquel
- Geodon
- Abilify
