Drug Therapy

• (AO1) Define drug therapy

  Drug therapy = a short-term, biological treatment for SZ.

  
  

  This therapy focuses on SZ at a chemical level, normalising neurotransmitter levels in order to reduce SZ symptoms.

  
  

  This mainly targets the struggling patient's positive symptoms (hallucinations and delusions) and negative symptoms (speech poverty and avolition), reducing them when the antipsychotic medication is taken.

  
  

  Thus improving the patient's daily functioning, but only to an extent.
• (AO1) Define typical antipsychotic medication

  Typical antipsychotic example = chlorpromazine.

  • They are dopamine antagonists.
  • They bind to dopamine receptors, particularly D2 receptors.
  • This then blocks stimulation of these receptors, so they cannot absorb dopamine.
  • As a result, this normalises neurotransmission, as postsynaptic cells receive less dopamine.

  Aim = treat only positive symptoms
• (AO1) Define atypical antipsychotic medication


  Atypical antipsychotic medication = Clozapine

  • They act on dopamine, serotonin and glutamate.
  • They occupy D2 receptors, causing a slower release of dopamine.
  • This then lowers the patient's dopamine levels.
  • This medication is usually helpful for those who have been treatment-resistant.

  Aim = treat both positive and negative symptoms
• (AO3) Side effects - typical.

  Point: A major limitation of typical antipsychotics is the severe side effects, which can reduce treatment adherence.

  
  

  Evidence: Patients often experience dry mouth, digestion problems, and sexual dysfunction. Patients can also experience more concerning effects like the 30% risk of developing tardive dyskinesia - a debilitating condition which causes uncontrollable shaking movements similar to Parkinson's.

  
  

  Evaluate: Side effects can significantly impact life quality, making patients less likely to continue treatment. This questions the long-term effectiveness of typical antipsychotics, as non-adherence may lead to an increased relapse rate and worsening symptoms.
• (AO3) Side effects - atypical

  Point: While atypical antipsychotics are preferred for fewer motor side effects, they still have significant impacts on a patient's quality of life.

  
  

  Evidence: Atypical antipsychotics can cause weight gain, increasing risk of stroke, diabetes and 5% risk of tardive dyskinesia.

  
  

  Evaluate: These side effects, can also negatively affect a patient's well-being, highlight the need to balance the benefits of symptom management with the physical consequences of the medication, emphasising the importance of a personalised treatment approach.
• (AO3) S - Lecht + 3%

  Point: Drug treatments for SZ highly effective in symptom reduction and improving life quality.

  
  

  Evi (1): Lecht et al found that antipsychotic were more effective than placebos, with patients on medication being only 27% likely to relapse compared to 64% for those on a placebo.

  
  

  Evi (1): Suggests antipsychotics significantly reduce relapse rates & symptoms, supporting their effectiveness in managing SZ.

  
  

  Eval (2): Less than 3% of SZ patients in UK permanently hospitalised, largely due to success of medications.

  
  

  Eval (2): Highlights effectiveness of drug therapies in enabling patients to live in the community, improving quality of life & benefiting economy by allowing them to return to work.
• (AO3) Limitation - consent + ability + first

  Point: Potential issues of appropriateness using drugs to treat SZ.

  
  

  Evidence (1): Consent issues, SZ p not aware of reality and not capable of giving informed consent to take meds. May have serious side effects.

  
  

  Evidence (2): May not have ability to take the meds continuously and as instructed. Some may require additional care to help with this.

  
  

  Evaluate: Appropriate to give drug therapy first. Enables them motivation, engage fully with other treatments (CBT) since avolition may prevent from having motivation for intensive therapies.
• (AO3) Interactionism

  Point: The combination of antipsychotics & psychological therapy supports the interactionist approach in treating SZ.

  
  

  Evidence: Guo et al (2010) found that patients who received a combination of antipsychotics and psychological therapy whilst in the early stages of SZ had =

  (1) improved insight & social functioning

  (2) less likely to relapse

  
  

  Evaluate: Supports idea that a combined treatment is palliative, addressing both biological and psychological factors.

  
  

  Also = other treatments, such as practical support like stable housing, could further enhance recovery, offering a more holistic approach to care.