Drug Therapy

Question 1

What are the two types of drugs used to modify schizophrenia?

Answer 1

Typical and atypical.

Question 2

Describe the use of Typical Drugs to modify schizophrenia.

Answer 2

Chlorpromazine antagonises D2 receptors in mesolimbic system within 48 hours. Dopamine receptors therefore inhibited.
Body responds by increasing dopamine secretion into synaptic cleft. Then, dopamine secretion reduced.
Targets positive symptoms.
Risk of tardive dyskinesia (twitch of face).

Question 3

Describe the use of Atypical Drugs to modify schizophrenia.

Answer 3

Clozapine works as a partial antagonist to serotonin and dopamine receptors when neurotransmitter levels are high. Precise mechanism is unknown. Reduces both positive and negative symptoms.
Risk of agranulocytosis (low neutrophil count).

Question 4

Evaluate the effectiveness of drug therapy (4 points, 3 for and 1 against.)

Answer 4

Cole et al (1964), 75% felt “much improved” after using typical drugs compared to 25% of placebo.
Awad (1999), atypical effectiveness 85% and typical 60%.
Davies et al (1989), 75% benefit from typical drugs short term.

DeNayer et al (2003) atypical only worked in 1/3 after typical failed.

Question 5

Evaluate ethics and social implications.

Answer 5

Protection from harm due to risk of agranulocytosis.
Szasz (1960) described as “chemical straightjackets” so lack valid consents.

Good for NHS as only drugs prescribed to reduce symptoms, no longer lifelong hospitalisation. Increased standard of public health due to more resources.