Biological Treatment for Sz: Antipsychotics

Question 1

When were the first APs developed?

Answer 1

In the 1950s

Question 2

What do APs attempt to do?

Answer 2

Attempt to balance the NTs in the brain

Question 3

What are the first generation of APs classified as?

Answer 3

Classified as typical APs

Question 4

What do typical APs aim to do?

Answer 4

Aim to block dopamine receptors in the brain

D2 receptors

Question 5

What is an example of typical APs?

Answer 5

Chlorpromazine which are phenothiazines

Question 6

What are typical APs described as being?

Answer 6

Described as being neuroleptics - acting at the neuron

Suppress positive symptoms

Question 7

How long do typical APs need to be taken to get the full benefit?

Answer 7

6 months

Question 8

What are the second generation of APs classified as?

Answer 8

Classified as atypical APs

Question 9

Which symptoms are atypical APs better at treating?

Answer 9

Negative and cognitive

Question 10

What are atypical APs mode of action like?

Answer 10

Works on other NTs such as glutamate and serotonin as well as dopamine

Question 11

Which AP seems to be the most effective?

Answer 11

Clozapine

Found to reduce suicidal feelings

Question 12

How long do patients need to take APs?

Answer 12

Depends on type of Sz

One psychotic episode - up to 2 years
Chronic Sz - lifetime medication

Question 13

What is the supporting evidence/strengths of antipsychotics as a treatment for Sz?

Answer 13

Meltzer et al (2004)

Leucht et al (2018)

Ethical

Rapid effect

Holistic approach

Question 14

What is the refuting evidence/weaknesses of antipsychotics as a treatment for Sz?

Answer 14

Rosa et al (2004)

Social control

Palliative

Reductionist

Side effects

Question 15

Why is Meltzer et al (2004) supporting evidence of antipsychotics as a treatment for Sz?

Answer 15

Meltzer studied 481 patients who were divided into two groups: placebo or haloperidol (AP) for six weeks

He noted a significant reduction in symptoms for those taking AP compared to placebo

Supports effectiveness of APs - reduces symptoms

Question 16

Why is Leucht et al (2018) supporting evidence of antipsychotics as a treatment for Sz?

Answer 16

Leucht conducted a meta-analysis consisting of over 6,000 patients with Sz

Compared rates of re-hospitalisation for those given APs (10%) with those given placebo (26%) suggesting medication was effective in reducing symptoms of Sz

Supports effectiveness of APs - reducing symptoms of Sz

Question 17

Why is ethics a strength of antipsychotics as a treatment for Sz?

Answer 17

APs viewed as both cheaper and more ethical way of treating patients who may previously have been institutionalised or treated with electro-convulsive therapy

Drugs allowed patients to remain living in the community whilst assessing other therapies

Supports usefulness of APs

Question 18

Why is rapid effect a strength of antipsychotics as a treatment for Sz?

Answer 18

Rapid effects compared to other types of therapy such as counselling because patients can be relieved of some symptoms in a matter of weeks

APs more easily accessible from NHS whereas psychological therapies may have extended waiting lists

Supports effectiveness - rapid effect in relieving symptoms

Question 19

Why is holistic approach a strength of antipsychotics as a treatment for Sz?

Answer 19

Appears to take an ‘eclectic’ or more holistic approach by combining the medication and counselling such as CBT or family therapy (to address the possible stressful triggers which may be involved in onset of symptoms)

Question 20

Why is Rosa et al (2004) refuting evidence of antipsychotics as a treatment for Sz?

Answer 20

Rosa found that only 50% of patients comply consistently with their medication regime for Sz which can often lead to relapses and re-admittance to hospital

Challenges effectiveness of APs as not all patients will remember to take them or will deliberately avoid taking them

Question 21

Why is social control a weakness of antipsychotics as a treatment for Sz?

Answer 21

Some argue that APs are ‘chemical straight-jackets’ and believe that prescribing such medication is a form of social control whereby doctors can enforce compliance to the medication regime through sanctions

Challenges ethics behind APs

Question 22

Why is palliative a weakness of antipsychotics as a treatment for Sz?

Answer 22

Some would argue APs are palliative and not curative meaning that they don’t address the causes of Sz, only masking the symptoms

Means the treatment isn’t fully effective

Challenges effectiveness of APs - underlying issues not addressed

Question 23

Why is reductionist a weakness of antipsychotics as a treatment for Sz?

Answer 23

Use of APs as a treatment for Sz may be challenged for being too simplistic and reductionist

Simply adjusting levels of NTs doesn’t address other social factors which may play a role in the onset of Sz

Doesn’t address other issues that may cause Sz such as social factors - focuses on biological factors

Question 24

Why is side effects a weakness of antipsychotics as a treatment for Sz?

Answer 24

APs often produce unpleasant side effects which themselves often require further drug treatment

Side effects of APs include weight gain, shaking, and tiredness. Such side effects may make the patient feel physically unwell

Raises issues with side effects of APs which may cause patient to avoid taking them