Drug Therapy: Atypical Antipsychotics

Question 1

Atypical or second-generation antipsychoticd work in a similar way to typical but have key differences

Answer 1

Include clozapine and are used with patients who have resisted treatment with typical drugs

Question 2

These drugs are DA antagonists they temporarily bind to DA receptors without stimulating them and block DA from activating post synaptic neurons

Answer 2

This temporarily reduces DA transmission and leads to reduction in positive symptoms

Question 3

The drug then rapidly dissociated from D2 receptors to allow normal transmission

Answer 3

This rapid dissociation reduces extra pyramidal effects due to the limited effect of the drug on DA systems involved in movement

Question 4

These drugs have an even greater effect on serotonin activity

Answer 4

They bind to a group of serotonin receptors called 5HT2a

This helps improve mood and reduce depression and anxiety in patients

Question 5

Supporting evidence for the effectiveness of antipsychotics from meta analysis from leucht

Answer 5

65 studies 6000 patients either placebo or typical/atypical antipsychotics
64% of placebo patients relapse
27% of antipsychotics had relapsed after 12 months

Supports effectiveness, stay symptom free for longer

Question 6

Advantages compared to typical antipsychotics

Answer 6

Extra pyramidal side effects are reduced
Rapid dissociation from the D2 receptors allow normal DA transmission
Increased serotonin transmission is more effective at reducing negative symptoms than typical drugs

More likely to continue more likely to be effective

Question 7

Ethical issues with drug therapy

Ross and Read

Answer 7

Calm patients, easier to control by hospital staff. Human rights violation “chemical straight jackets”

Reinforce the patients view something id wrong with “them” reduces motivation to look for possible stressors that contribute to their condition

Less likely to seek solutions that might reduce suffering, damaging for recovery