Biological Therapies for Sz.

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  • Biological Therapies for Sz.
    • Drugs
      • A typical Anti psychotics
        • Effectiveness
          • Claim that atypical anti psychotics are effective with - systems has marginal support.
        • Appropriateness
          • A typical drugs may ultimately be the most appropriate in treating sz because fewer side effects.
            • Patients more likely to continue meds & therefore see more benefit.
          • Side effects include weight gain, sleepiness, low energy % reduction in white blood cells.
          • Jeste et al: found tar. dys. rates in 30% of patients after taking conventional drugs, 5% for a typical.
        • Also act on dop system but only temporarily occupy D2 receptor & rapidly dissoculate to allow normal dop transmission.
      • Conventional Anti psychotics
        • Appropriateness
          • Rzewuska: drugs usually reduce symptoms within 6 months but often return if medication is stopped.
          • Ross & Reid: argue being prescribed meds reinforces idea that 'something is wrong with me' preventing patients from thinking of possible stressors causing condition, reducing motivation to look for solutions that might alleviate stressors.
          • Tardive dyskinesia is a side effect.
            • Hill: 30% of patients taking drugs develop tar. dys. It is irreversible in 75% of cases.
        • Effectiveness
          • Davis et al: analysed results of 29 studies. Relapse occured for 55% of patients whos drugs were replaced with placebo. 19% for those who stayed on the drug.
            • Ross & Reid: say figures from Davis are misleading. 45% benefited from placebo & 81% from drug.
          • Vaugnand & Left: found anti psychotics did make a significant difference but only for those living in a hostile & critical home environment,
          • Side effects include visual disturbance, drowsiness, dryness of the mouth, changes in weight & depression.
          • Dosage of meds is difficult to gauge due to individual difference in patients.
          • About 30% of patients do not respond to drug.
          • Adverse side effects can stop patients taking meds, leading to revolving door syndrome.
          • These drugs dont seem effective against - symptoms.
        • Dop antagonists bind to dop receptors without stimulating them, so blocking their action. Can eliminate hallucunations/ delusios experienced by sz patients.
    • How Science Works
      • Who decides the patient is cured? In whose interest is it to decide the patient is cured? Who decides the patient is ill in the first place? Should the placebo be used first? Is it ethical to test therapies?
    • Electro-Convulsive Therapy
      • Electric current passed through 2 scalp electrodes creating a seizure. Patients injected with barbiturate so they are unconcious & given nerve-blocking agent to paralyse muscles to stop fractures.
        • Risks associated with ECT include memory dysfunction, brain damage, congnitive impairments and even death. It is a short lasting cure and we dont know how it works so use of ECT has declined.
      • American Association review compared ECT & placebo. Concluded ECT produced results no worse or different than anti-psychotic meds.
      • Tharyan & Adams: found compared to placebo more people improved in real condition. Compared with anit-psychotics, meds appeared more effective. ECT could be appropriate when rapid reduction of symptoms is required or when patient shows limited response to meds.
      • Sarita et al: found no difference in symptom reduction between sz patients given ECT or placebo.
      • Idea for ECT as treatment of sz followed reports that dementia praecox was rare in patients with severe epilepsy. Seizures somehow reduced symptoms of disorder.
        • Early studies for clinical treatment were disappointing. Karagulla: found lower rates of recovery for ECT patients compared to those who didnt recieve it.
    • Before 1950's treatment was primitive, most severly disturbed individuals were institutionalised.


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