drug therapy treatment

Question 1

how do anti-p work

Answer 1

used to reduce schiz symptoms by reducing transmission of dopamine

Question 2

typical anti-p

Answer 2

• chlorpromazine
• used to combat positive symptoms (hallu/delu) that are caused by excess of dopamine
• used first

Question 3

atypical anti-p

Answer 3

• clozapine
• lower risk of extrapyramidal side effects/movement problems
• help negative side effects & cognitive impairment
• gets rid of both symptoms

Question 4

typical anti-p - how do they work

Answer 4

• dopamine antagonists - bind to dopamine neurotransmitter & block them
• reduces dopamine in mesolimbic pathway & eliminates positive symptoms like hallucinations & delusionS

Question 5

typical anti-p - what happens to symptoms

Answer 5

• hallucinations & delusions are gone within few days
• other symptoms can take several weeks before being improved

Question 6

typical anti-p - possible side effects

Answer 6

• to be effective, must block between 60-75% dopamine receptors in meso-limbic pathways
• cannot be achieved without blocking dopamine receptors in other parts of brain like mesocortical pathway
  leads to undesirable effects

Question 7

atypical anti-p - how do they work

Answer 7

• dopamine antagonists - bind to dopamine receptors & temporarily blocks them
• reduces dopamine in mesolimbic pathway & eliminates positive symptoms like hallucinations & delusions

Question 8

atypical anti-p - what is rapid dissociation in use of anti-p

Answer 8

• after binding to receptors these atypical anti-p rapidly dissociate & allow normal dopamine transmission
• means lower extrapyramidal (neg) effects

Question 9

atypical anti-p - differences between typical & antitypical

Answer 9

• typical anti-p only black dopamine receptors
• atypical anti-p bind & block serotonin receptors as well
• schiz can suffer from excess of serotonin & too much can lead to muscle seizures

Question 10

evaluation 1

Answer 10

ANTI-P VS PLACEBO: Leucht carried out meta analysis of 65 studies with 600 patients. some taken off anti-p & given placebo. within 12m, 64% placebo group relapsed compared to 27% of those on anti-p
STRENGTH: anti-p clearly effective at reducing relapse
EXTRA PYRAMIDAL SIDE EFFECTS: typical anti-p drugs can sometimes lead to movement issues as effect extrapyramidal part of brain that helps to control motor activity. people may shake/have seizures
LIMIT: side effects can be distressing

Question 11

evaluation 2

Answer 11

ADVANTAGE OF ATYPICAL: less likely to produce negative effects commonly found with typical anti-p so more likely to continue with meds
STRENGTH: reduction in symptom without much cost
MOTIVATIONAL DEFICITS: some argue when patient prescribed with anti-p it reinforces idea there’s something wrong with them preventing them from looking for causes & reduces motivation for treatment
LIMIT: become dependent on drug

Question 12

issue & debate

Answer 12

ETHICAL ISSUES
- can lead to TD (stiff/jerky movements) and with such side effects critics say these are inhuman & degrading treatments none should be subjected too