Biological therapies for schizophrenia

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  • Created by: z_mills1
  • Created on: 08-05-15 17:00

Antipsychotic drugs

Conventional/typical antipsychotics - combat positive symptoms

  • reduce the effects of dopamine and so reduce the symptoms of schizophrenia
  • dopamine antagonists -> they bind to dopamine receptors (particularly the D2 receptors) but do not stimulate them, thus blocking their action.
  • by reducing stimulation of the dopamine system in the brain, antipsychotic drugs (e.g. chlorpromazine) can eliminate the hallucinations and delusions experienced by people with schizophrenia.

Effectiveness

  • Davis et al (1980) -> compared relapse rates with those on a placebo 
  • found a significant difference in terms of relapse rates between treatment and placebo in every study reviewed, thus demonstrating the therapeutic effectiveness of these drugs.
  • However, a more recent analysis of that study by Ross and Read has suggested that its results were misleading: as all those studied, including those who took placebos, were on antipsychotics before this study began, it was, rather than a study comparing treat to non-treatment, a comparison between continued treatment and withdrawn treatment.
  • Ross and Read suggest a significant proportion of the relapses in the placebo group can be explained by these withdrawal symptoms, leaving the conclusions drawn by Davis discredited.

Appropriateness

  • side effects -> development of tardive dyskinesia- uncontrollable movements of the lips, tongue, face, hands and feet- in 30% of patients taking typical antipsychotics, with only 25% of these cases treatable.
  • some suggest that given this side effect, administration of these drugs is unethical, and defies articles regarding harmless treatment in the Human Right Acts 1988.
  • Therefore, physicians prescribe conventional antipsychotics less frequently than they used to because of the potential for serious side effects. Instead, physicians often preferentially prescribe a newer family of antipsychotic medications, known as atypical antipsychotics.

Atypical antipsychotics

  • Atypical antipsychotics also act on the dopamine system, but are thought to block serotonin receptors in the brain too.
  • Kapur and Remington however suggest that these drugs do not involve serotonin or other neurotransmitters, but only the dopamine system and the D2 receptors in particular.
  • They help by only temporarily occupying the D2 receptors and then rapidly dissociating to allow normal dopamine transmission.
  • It is this characteristic of atypical  antipsychotics

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