Biological Treatments for Schizophrenia

  • Created by: nwheway
  • Created on: 06-03-19 19:38
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  • Biological Therapies of Schizophrenia
    • Drug Therapies
      • The most common treatment for schizophrenia is the use of antipsychotic drugs.
      • Can be administered via injection every 2-4 weeks for patients like to forget to take their medication.
      • Antipsychotics can be required short or long term.
    • Typical Antipsychotics
      • Chloropromazine
        • Can be taken as tablets, injection or syrup - max does of 1000mg
        • Works by acting as antagonists in the dopamine system - reduce the action of neurotransmitters by blocking receptors in the synapse to the brain, reducing the action of dopamine.
          • Normalises neurotransmission in key areas of the brain, reducing symptoms like hallucinations.
        • Also works as a sedative - can be used to calm patients when they are first admitted to hospitals and are very anxious.
      • Introduced in the 1950's.
    • Atypical Antipsychotics
      • Have been around since the 1970's
      • Aim to create a newer drug that maintains or improves upon the effectiveness of drugs in suppressing symptoms, as well as minimising side effects.
      • Clozapine
        • Developed in the 1960's, trailed in the 1970's.
        • Was withdrawn from use due to deaths of patients from a blood condition.
          • People who now take it have to have regular blood tests
        • Clozapine binds to the dopamine receptors in the same was that clorapromazine does but in addition it acts on the seretonin and glutamate receptors. it is believes that this action helps to improve mood and reduce depression and anxiety in patients.
          • Due to its mood enhancing properties it is often prescribed to patients that are suicidal - 30-50% of Sz suffers attempt suicide.
      • Risperidone
        • was developed around the 1990's
        • was designed to be as effective as clozapine but without the serious side effects.
        • can be taken as a tablet, syrup or injection.
        • risperidone binds to the dopamine and serotinin receptors. it binds more strongly than clozapine does and is therefore effective in smaller doses - could be why it has less side effects.
    • AO3
      • Evidence for effectiveness
        • Thornley reviewed studies comparing effects of chlorpromazine to control conditions in which patients received a placebo so their experiences were identical except for the presence of chlorpromazine in their medication. data from 13 trials with a total of 1121 participants showed that chlorpromazine was associated with better overall functioning and reduced symptom severity.
      • Serious Side Effects
        • Side effects can range from mild to severe to fatal. side effects can include dizziness, agitation, sleepiness and more, as long as long term effects being dopamine hypersensitivity causing involuntary facial movements. the most serious side effect is neuroleptic malignant syndrome caused by drugs blocking dopamine action in the hypothalamus, which can be fatal.
      • Use of Antipsychotics Depends on the Dopamine Hypothesis
        • quite a bit of evidence shows that this original dopamine hypothesis is not a complete explanation for Sz, and that in fact dopamine levels in parts of the brain other than the subcortex are too low rather than too high. if this is true then it is not clear how antipsychotics work when they reduce dopamine activity.
      • Problems with Evidence for Effectivness
        • Healy suggests that some successful trials have had their data published multiple times, exaggerating the evidence for positive effects. he also suggested that because antipsychotics have powerful calming effects on patients - which is not the same as saying they reduce psychosis.
      • Chemical Cosh Argument
        • Antipsychotics are used in hospitals to calm patients and make them easier to work with for staff, rather than for the benefits to the patients themselves. although short term use of drugs to calm agitated patients is recommended by NICE this can be seen as human rights abuse.

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