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Flashcards in Biological Therapies Deck (17):

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


Atypical antipsychotic drugs

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


Electroconvulsive therapy (ECT)

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


Davis et al (1980)

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


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.


Conventional antipsychotic - tardive dyskinesia

30% develop, irreversible in 75%


Motivational deficits

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


Atypical vs. conventional

meta-analysis, superiority of atypical only moderate


Effectiveness of atypical antipsychotics

only marginal support for effectiveness with negative symptoms


Atypical - lower likelihood of tardive dyskinesia

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


Atypical - fewer side effects so

more likely to continue medication, more benefits


Effectiveness of ECT - APA

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


Effectiveness of ECT - Indian study

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


Appropriateness of ECT - risks

include memory dysfunction, brain damage
led to declined use


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


Ethical issues

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


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