treatments of schizophrenia Flashcards
define effectivness
how well the drug can work to improve the state of a person
define appropriateness
how suitable the drugs the person are receiving are towards their mental disorder
what are the type of drugs called that sz patients take
anti-psychotics (neuroleptics)
what are the two categories of antipsychotics
- typical (conventional)
- atypical
what are typical drugs
eg chlorpromazine
reduces the amount of dopamine and so reduces symptoms. binding to dopamine receptors and thus blocking their action, not stimulating them
what are atypical drugs
eg risperidone or clozapine
also treats the negative factors. also block serotonin receptors and bind to D2 receptors, they temporarily bind to the receptors and then rapidly dissociate to allow normal dopamine transmission
what is the appropriateness of drug therapy
- drugs treat the symptoms of the disorder but not the cause
- an antipsychotic drugs cannot seek out and kill the cause
- we don’t know for sure what causes sz
- some serious side effects of using the drugs
- between 20-25% of sufferers will suffer from some form of disordered motor movements like tremors and involuntary tics
- this is a reason why 50 % of sufferers stop taking drugs within the first year. however the newer forms are more effective nd have less side effects
- not all sufferers will react in the same way
- around 30% react unfavourably
effectiveness of drug therapy
- for most sufferers, drugs successfully calm the symptoms of sz
- SILVERMAN stated that the antipsychotics have beneficial side effect for some people like increasing levels of attention and information processing
- chlorpromazine is the most widely used antipsychotic
- chlorpromazine has been found be more effective than phenothiazines
evaluation of drug therapy
- sometimes people stop taking the drugs because side effects are so terrible
- all drugs do is reduce symptoms not the cause
- rapidly reduces the most disturbing symptoms allowing people to live a normal life
- reduces the amount of time people have to spend in hospitals
- DAVIS analysed the result of 29 studies. found that relapse occurred in 55% of those who took placebos compared to 19% of those who remained on the drugs
- VAUGHN AND LEFF found that drugs make a sig difference for those living in hostility - relapse rate for patients in these condition on meds was 53% compared to placebo which was 92%. however in another study there was no sig difference drug group was 12% compared to 15% placebo group
what is the social treatment of schizophrenia
care in the community as a response to psychiatric hospitals being closed in 1958
sometimes called assertive community therapy in usa
what are the needs of people who have just come out of hospital
cleaning medication hygiene food therapy housing helplines clothes
who helps people just out of hospitals
social worker community psychiatric nurse family job centre key worker counsellor half way houses
nice characteristics of care in community
1) focus on those who need most help from the community health service
2) support independence, rehabilitation and recovery to avoid homelessness and re-hospitalisation
3) treatment in a real life setting - patients are visited and helped rather than offered therapies
4) whole team focus on individual - psychiatrists, nurses and social workers
5) time - a commitment to spend as much time as necessary to rehabilitate and support, offering a holistic treatment that looks at all the individuals needs in a multidisciplinary approach
who makes up the multi-disciplinary team
homecare = help in the home, feeding, dressing, grooming, reminders
key worker = form filling for benefits
day centres = this is a lot cheaper than residential care, may look after people for up to 7 days a week but are not residential
crisis intervention centre= based on the idea that it is best to keep people out of hospital there are 24 hour facilities
half way houses = a type of warden assisted or shared home where a person can get used to independent living which support
strengths of care in the community
- offers support to individuals
- real life setting
- multi-disciplinary approach
- improve quality of life
- low client to staff ratio 10:1
- 80% of time spent in natural environment
- helps people to stay with their family instead of being in hospital which offers extra life long support
- not forced into an institution
