Biological therapies: Drug therapy

• Biological therapies: Drug therapy


  Typical antipsychotics

  Have been around since the 1950s and include Chlorpromazine - can be taken as tablets, syrups or injections. Typical prescribed doses have declined over the last 50 years. Act as dopamine antagonists by blocking dopamine receptors in the synapses of the brain, reducing the action of dopamine. According to the dopamine hypothesis of schizophrenia, this dopamine-antagonist effect normalises neurotransmission in key areas of the brain, reducing symptoms like hallucinations.
• Biological therapies: Drug therapy


  Typical antipsychotics 2

  As well as having antipsychotic properties chlorpromazine is also an effective sedative. Chlorpromazine is often used to calm people w/ schizophrenia when they are first admitted to hospitals and are very anxious.
• Biological therapies: Drug therapy


  Atypical antipsychotics

  Have been used since the 1970s. The aim in developing newer antipsychotics was to maintain or improve upon the effectiveness of drugs in suppressing the symptoms of psychosis and minimise the side effects.
• Biological therapies: Drug therapy


  Atypical antipsychotics 2

  Clozapine

  Clozapine is used as a treatment for Sz when other treatments fail. Clozapine binds to dopamine receptors in the same way Chlorpromazine does, but also acts on serotonin and glutamate receptors. It is believed that this action helps improve mood and reduce depression and anxiety. The mood-enhancing effects of Clozapine means it is sometimes prescribed when someone is considered at a high risk of suicide. This is important because 30-50% of people w/ Sz attempt suicide at some point.
• Biological therapies: Drug therapy


  Atypical antipsychotics 3

  Risperidone

  Was developed in an attempt to produce a drug as effective as Clozapine but without its serious side effects. Like Clozapine, Risperidone is believed to bind to dopamine and serotonin receptors, but binds more strongly to dopamine receptors and is effective in much smaller doses than most antipsychotics. There is some evidence to suggest that this leads to fewer side effects than is typical for antipsychotics.
• Biological therapies: Drug therapy - evaluation


  Evidence for effectiveness of typical antipsychotics. Thorney et al. (2003) reviewed studies comparing the effects of Chlorpromazine to control conditions in which people w/ SZ received a placebo. Data from 13 trials w/ a total of 1121 ppts showed that Chlorpromazine was associated w/ better overall functioning and reduced symptom severity. Data from 3 trials w/ a total of 512 ppts showed that relapse rate was also lower when Chlorpromazine was taken.
• Biological therapies: Drug therapy - evaluation 2


  Evidence for effectiveness of atypical antipsychotics. In a review Meltzer (2012) concluded that Clozapine is more effective than typical antipsychotics and other atypical psychotics, and that it is effective 30-50% of treatment-resistant cases where typical antipsychotics have failed.
• Biological therapies: Drug therapy - evaluation 3

  Drug therapy could be considered unethical. It is widely believed that antipsychotic drugs have been used in hospital situations to calm people and make them easier for staff to work w/, rather than for the benefits to the people themselves. Although short term use of antipsychotics to calm agitated people is recommended by the National Institute for Health and Clinical Excellence (NICE), this practice is seen by some as a human rights abuse.