Biological therapies for schizophrenia

  • Created by: Saf54
  • Created on: 19-02-19 11:21
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  • Biological therapies for schizophrenia
    • Typical antipsychotics
      • Chlorpromazine is taken orally, around 1000mg daily and doses increase overtime
        • It is also an effective sedative and has an effect on histamine receptors
        • Used to calm patients with and without schizophrenia and is usually done when they’re first admitted to hospital when they’re anxious/nervous
        • Syrup is absorbed quicker than tablets so is taken in the form of syrup when used as a sedative
      • Strong association between use of typical antipsychotics and dopamine hypothesis
        • They act as antagonists in the dopamine system
          • Antagonists are chemicals that reduce the action of the neurotransmitter
        • Block dopamine receptors in the synapse of a brain so reducing the action of dopamine.
          • Chlorpromazine builds up the dopamine then reduces it .
          • Dopamine antagonists effect normalises neurotransmissions so reduces symptoms such as hallucinations in the brain
      • 1950’s
    • Atypical antipsychotics
      • Clozapine was withdrawn due to deaths of patients from a blood condition called agranulocytosis
        • Remarketed in 1980’s as other treatments failed but patients have regular blood tests
        • Fatal side effects so not available as an injection
      • 1970’s
      • Risperidone has been recently developed and doesn’t have as serious side effects as clozapine
        • Binds to dopamine and serotonin receptors but it binds more strongly than clozapine
          • It’s a more effective,smaller antipsychotic and has fewer side effects
    • Positives
      • Evidence for effectiveness
        • Thornley et al (2003) compared effectiveness of chlorpromazine to control conditions
          • People were given a placebo aswell
          • Data from 13 trials with a total of 1121 ppts showed chlorpromazine had better overall functioning and reduced symptom severity
            • Data from 3 trials with 512 ppts showed relapse rate was lower when chlorpromazine was used
        • Atypical antipsychotic- Meltzer(2012)  concluded that clozapine is more effective than typical antipsychotics
          • 30-50% more effective of treatment resistant cases where typical antipsychotic have failed
    • Negatives
      • Serious side effects such as dizziness, agitation, sleepiness, stiff jaw, weight gain and itchy skin
        • Long term effects are tardive dyskinesia which is caused by dopamine super sensitivity and leads to involuntary facial movements
        • Most serious side effect is neuroleptic malignant syndrome(NMS)
          • Drug blocks the dopamine in the hypothalamus and results in high temp,delirium and coma
      • Problems with evidence for effectiveness
        • Healy (2012) said that successful trails have been published multiple times and have been exaggerated
        • Antipsychoticshave a calming effect so it’s easy to say they have positive effects, it’s not the same as saying they reduce the severity of psychosis
      • Use of antipsychotic depends on the dopamine hypothesis
        • High levels of dopamine activity in the sub cortex of the brain
          • Evidence to suggest the dopamine hypothesis isn’t a complete explanation for schizophrenia
            • Some parts of the brain could have low levels of dopamine which isn’t how antipsychoticswork as they’re dopamine antagonists

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