Biological Therapy for Schizophrenia

• What are antipsychotics used for?

  To reduce symptoms of psychotic disorders
• What are the two types of antipsychotics?

  • Typical Antipsychotics
  • Atypical Antipsychotics
• What generation of drugs are typical antipsychotics?

  First generation for schizophrenia
• How do typical antipsychotics work?

  They act as dopamine antagonists
• What is the role of dopamine antagonists?

  To block dopamine receptors in the brain
• What additional effect does chlorpromazine have?

  It acts as an effective sedative
• How is chlorpromazine believed to induce sedation?

  By affecting histamine receptors
• How is chlorpromazine administered for sedation?

  Often given as a syrup
• What characterizes atypical antipsychotics?

  • Developed after typical antipsychotics
  • Target a range of neurotransmitters
  • Reduce both positive and negative symptoms
• What receptors does clozapine bind to?

  Dopamine, serotonin, and glutamate receptors
• What benefits does clozapine provide?

  Improves mood and reduces anxiety
• When might clozapine be prescribed?

  When at high risk of suicide
• Why is clozapine not available by injection?

  Due to potential fatal side effects
• What monitoring is required for patients on clozapine?

  Regular blood tests for agranulocytosis
• How does risperidone differ from clozapine in receptor binding?

  It binds more strongly to dopamine receptors
• What evidence supports the effectiveness of antipsychotics?

  • Large body of evidence exists
  • Thornley et al (2003) study shows chlorpromazine improves functioning
  • Associated with reduced symptom severity compared to placebo
• What flaws did Healy (2012) identify in antipsychotic effectiveness studies?

  Short-term effects and data publication issues
• Why might the evidence for antipsychotic effectiveness be misleading?

  Powerful calming effects can mask true effectiveness
• What is a serious side effect of typical antipsychotics?

  Tardive dyskinesia
• What causes tardive dyskinesia?

  Dopamine supersensitivity from long-term use
• What is the most serious side effect of antipsychotics?

  Neuroleptic malignant syndrome
• What symptoms are associated with neuroleptic malignant syndrome?

  High temperatures and delirium
• What is the original hypothesis related to antipsychotic mechanisms?

  The dopamine hypothesis and hyperdopaminergia
• Why is the original dopamine hypothesis considered reductionist?

  Dopamine levels are too low in some brain areas
• What implication does the reductionist view have on antipsychotic treatment?

  Some antipsychotics may not be the best treatment
• What are the potential harms of antipsychotic drugs?

  • Can cause serious side effects
  • May lead to avoidance of treatment
  • Effectiveness can be questioned