What kind of therapy does the biological approach propose for Sz ?
Drug therapy and the use of anti-psychotics
how can typical anti-psychotics be taken and how long for ?
Anti-psychotics can be taken as
- Tablets
- Syrup
- Injection’s for those at risk every 2-4 weeks
May be taken short term or long term
What can typical anti-psychotics be divided into ?
Typical anti-psychotics
Atypical anti-psychotics
What are typical anti-psychotics ?
Include Chlorpromazine
Can be taken as a tablet, syrup or injection
Orally administered = daily dose max 1000mg
Dose has declined over past 50 years
What does chlorpromazine have a strong association with and why ?
Strong association with dopamine.
Because chlorpromazine acts as an antagonist in the dopamine system, reducing the action of neurotransmitters.
How do dopamine antagonists work ?
Dopamine antagonists;
- Block dopamine receptors in synapse of brain reducing action of dopamine.
- At 1st dopamine production is increased when med’s are taken and then reduced.
How do typical anti-psychotics reduce symptoms such as hallucinations?
The drugs normalise neuro-transmission in key areas of the brain reducing symptoms
Why is chlorpromazine often used for Sz patents?
Chlorpromazine is often used to calm patients with Sz and other conditions.
This is often done when the patient is in hospital for the 1st time.
what form of typical anti-psychotics work the quickest ?
Syrup
What was aim of a-typical anti-psychotics and give 2 examples of a-typical anti-psychotics
Aim: The aim was to produce drugs that were more effective and to minimise side effects.
A-typical anti-psychotic: Clozapine & Recperidone
What is the history of Clozapine ?
60’s - developed
70’s - trialled
70’s - withdrawn to the deaths of patients who got a blood condition
80’s - discovered to be more effective than some drugs so used only when other treatments have failed.
What is the maximum dosage of clozapine and what are patients required to do if they are administered this drug ?
Dosage = 300/450mg (cant be injected Requirements = regular blood tests
How does Clozapine work and how does it affect patients ?
Work: Clozapine binds to dopamine and acts on serotonin and glutamate receptors. Affects: improves mood reduces depression and anxiety may improve cognitive functioning
What kind of patients is Clozapine normally administered to and why ?
suicidal patients
Because clozapine enhances mood and this is important as 30-50% of patients attempt suicide
Why was Recperidone produced and how is it administered (include dosage) ?
Recperidone was produced as a safer alternative to clozapine.
Administered: Tablet , syrup or injection that lasts 2 weeks.
Dosage: start - 4-8mg and max 12mg
How does recperidone work ?
Binds more strongly to dopamine receptors and therefore effective in a much smaller dosage
What is a strength of typical anti-psychotics and what evidence is there to support this ?
-Evidence to support the effectiveness of Chlorpromazine
Thornley et al: compared studies comparing effects of chlorpromazine and controls.
Found:
CH was associated with better overall functioning
Reduced symptom severity
Relapse rate reduced
AO3
What is a strength of a-typical anti-psychotics and what evidence is there to support this ?
-Evidence supporting effectiveness
Meltzer:
Concluded:
Clozapine is more effective than typical psychotics
30-50% cases where typical antipsychotics have failed
AO3
What is a weakness of risperidone and what kind of drug is this ?
A-typical antipsychotic
Limitation : Evidence can not exclusively support this drug
Studies comparing riciperidone and clozapine have produced inconclusive drugs.
Potentially, may be that patients react differently to different drugs
AO3
Identify 2 limitations of typical anti-psychotics
Typical Anti-psychotics
Serious side effects: sleepiness, stiff jaw, weight gain, dizzy
Long term: Neuroleptic maligant syndrome causes dopamine blocking and can result in high temp’s, delirium.
AO3
Identify 3 limitations of the use of drug therapy and antipsychotics
Limitations of anti-psychotics
- unclear if antagonists can reduce dopamine activity
- Believed they’re use to calm patients for staff rather than benefiting patients
- Problems with evidence: Healy suggested successful trials have repeatedly published data for exaggeration
- Studies only show ST not LT use difficult to determine