drug therapy

Question 1

what are antipsychotics?

Answer 1

• a chemical treatment based on the dopamine hypothesis
• they help the patient improve their functioning and well-being but don’t cure the illness

Question 2

typical antipsychotics

Answer 2

• they primarily combat pos symptoms
• they are dopamine antagonists, they bind to dopamine receptors (particularly d2 receptors)
• by binding to the receptors, this reduces their action and blocks their stimulation so they cannot absorb the dopamine
• reducing stimulation in the mesolimbic system in the brain means the drugs can eliminate hallucinations and delusions
• this eventually normalises neurotransmission by ensuring postsynaptic cells receive less and can’t be affected by dopamine

Question 3

give a limitation of typical antipsychotics
1/1

Answer 3

it’s estimated that 60-70% of d2 receptors must be blocked for typical antipsychotics to be effective. due to this a similar number of d2 recepts in other areas of the brain must also be blocked, which causes side effects. one side effect is tardive dyskinesia, which can cause patients to stop taking their medication. although blocking dopamine receptors in one of the many dopamine pathways in the brain is useful, blocking them in other pathways like these do can be harmful to the patient.

Question 4

atypical antipsychotics

Answer 4

• combat pos symptoms but there are claims they also work on neg symptoms
• they work on dopamine receptors but also block serotonin and glutamate receptors
• they work by temporarily occupying the d2 receptors and rapidly dissociating the dopamine
• this means the receptors still receive dopamine, just in smaller levels

Question 5

give a strength of atypical antipsychotics
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Answer 5

done cause the same issues with movement as typical antipsychotics, for example, they actually reduce the chances of tardive dyskinesia. jeste et al (1999) found 30% of patients on typical compared to 5% on atypical (for 9 months) suffered from tardive dyskinesia

Question 6

give a strength of atypical antipsychotics
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Answer 6

more appropriate in treating sz as there are fewer side effects, so patients are more likely to continue their meds and see more improvement. they are not side effect free however, and are associated with diabetes for example

Question 7

give a limitation of atypical antipsychotics
1/1

Answer 7

research contradicts the claim that atypicals are more effective at treating sz. leucht et al (1999) did a meta analysis and found 2 of the atypical drugs were only slightly more effective than typical drugs, one was effective and the other slightly worse. furthermore the claim that atypicals are good at treating neg symptoms has very little research support. this indicates that atypicals may not be a superior treatment

Question 8

differences between typical and atypical antipsychotics

Answer 8

1. atypicals have less risk of extrapyramidal side effects like tardive dyskinesia
2. research indicates atypicals have a beneficial impact on neg symptoms
3. atypical are suitable for treatment-resistant patients, they’re more likely to work when typicals have failed

Question 9

give a strength of drug therapy
1/2

Answer 9

effective in reducing sz symptoms, specifically pos symptoms. they are fairly cheap to produce making them cost-effective, they are easy to administer and have pos effects on many people allowing them to give relatively normal lives. it’s estimated less than 3% of those with sz live in hospitals permanently due to medication. this highlights that drug treatment is successful for the majority of people with sz, allowing them to live happily in the community

Question 10

give a strength of drug therapy
2/2

Answer 10

drugs are more effective than placebos. lecht et al (2012) found patients who remained on their antipsychotic meds were 27% likely to relapse compared to 64% for those given a placebo. this highlights that drugs are successful in reducing the chance of relapse

Question 11

give a limitation of drug therapy
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Answer 11

drugs only treat the symptoms of sz, not offering a cure. so if a patient were to stop taking their medication, their symptoms would return. this can lead to the ‘revolving door phenomenon’, patients take their medication and feel better, then wrongly assume they are better and stop taking their meds, leading them to be ill again and be hospitalised

Question 12

give a limitation of drug therapy
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Answer 12

there are ethical issues with the use of antipsychotic medication. if side effects, death and social consequences are accounted for, a cost-benefit analysis would be negative. many people within the psychiatric community see the widespread use of antipsychotics as fuelled by drug-producing companies, who make huge profits from their continued use