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Schizophrenia > Biological Therapies > Flashcards

Flashcards in Biological Therapies Deck (17):
1

Conventional antipsychotic drugs (e.g chlorpromazine)

dopamine antagonists, bind to D2 receptors, block action
reduce stimulation of dopamine system, eliminate positive symptoms
effectiveness led to dopamine hypothesis

2

Atypical antipsychotic drugs

block serotonin, temporarily occupy D2
dissociate, allow normal dopamine transmission
lower level of side effects

3

Electroconvulsive therapy (ECT)

injected with barbiturate, unconscious
given nerve-blocking agent, paralyse muscles
0.6 amps electric current, 1 min. seizure
3-15 treatments

4

Davis et al (1980)

55% relapse of placebo
19% in those who remained on drugs

5

Other factors - environment

Vaughn and Leff (1976): medication made diff. for those with hostility and criticism in home
Relapse on medication 55%, placebo 92%
Supportive home, no sig. diff.

6

Conventional antipsychotic - tardive dyskinesia

30% develop, irreversible in 75%

7

Motivational deficits

Ross and Read (2004): medication reinforces there is something wrong
prevents individual thinking about possible stressors that trigger SZ

8

Atypical vs. conventional

meta-analysis, superiority of atypical only moderate

9

Effectiveness of atypical antipsychotics

only marginal support for effectiveness with negative symptoms

10

Atypical - lower likelihood of tardive dyskinesia

Jeste et al (1999): 30% of people after 9m treatment with conventional
5% those treated with atypical

11

Atypical - fewer side effects so

more likely to continue medication, more benefits

12

Effectiveness of ECT - APA

American Psychiatric Association review (2001) listed 19 studies comparing ECT and stimulated
results no diff. to medication

13

Effectiveness of ECT - Indian study

no diff. in symptom reduction between 36 SZ patients given stimulated/ ECT

14

Appropriateness of ECT - risks

include memory dysfunction, brain damage
led to declined use

15

Appropriateness of ECT - Tharyan and Adams (2005)

reviewed 26 studies, ECT more effective than sham
long/medium term advantage?
evidence suggest ECT + drugs - greater improvement in mental state, may be required if patients show little response

16

Ethical issues

side effects, deaths, psychological consequences
cost-benefit analysis of advantages would be negative

17

Are placebo studies a fair test?

Ross and Read (2004): placebo condition - patient in withdrawal state, blocked dopamine sys. flooded with DA due to heightened sensitivity and increased receptors - overwhelmed
placebo responses explained by withdrawal effects