Biological Treatments

• Typical antipsychotics - chlorpromazine

  Atypical antipyschotics - clozapine and risperidone
• Typical antipsychotics are dopamine antagonists.

  They are effective in reducing dopamine activity. They block dopamine receptors at the post synaptic membrane. Believed to normalise neurotransmission in key areas relating to symptoms.
• Atypical antipsychotics eg closapine and risperidone.

  Block dopamine receptors, similar action to typical drugs but this is more temporary.

  They also act on other neurotransmitters such as gluatamate and serotonin. Also address negative symptoms such as avolition/low mood.
• Thornley et al (2003)

  Reviewed studies looking at the effects of chlorpromazine in comparison to placebos (typical)

  1121 participants across 13 trials showed high efficacy of chlorpromazine in reducing symptom severity and increasing functionality

  Evidence of relapse being lower
• Meltzer 2012

  Atypical antipsychotics are more effective than typical antipsychotics, more so in treatment resistant cases (up to 50%)
• Atypical

  A potentially fatal side effect is a risk of antipsychotics - called agranulocytosis. Estimated to affect approximately 2% of all clozapine users. Those on this drug require regular blood tests.
• typical antipsychotics are associated with Tardive dyskinesia, where a person loses motor control and atypical antipsychotics run a small risk of agranulocytosis which can be fatal.
• Therefore for drug therapies to be effective a cost benefit analysis approach should be taken meaning the efficacy is weighed up against side effects and/or cost to NHS.”
• Some argue that the effects of antipsychotics are to sedate the patient which is an ethical issue. They are made more "manageable" by being put in a "chemical cosh".The benefit may be for others, not the actual patietn
• • There are similarities and differences in the two drug treatments​
  • Both reduce positive symptoms but Atypical also address negative symptoms by targeting serotonin​
  • Typical drugs have HIGHER risk of side effects because they bind for longer and are less selective at binding​
  • Atypical drugs seem to have fewer side effects because they are temporary and selectively bind at the synapse​
  • Typical have no sedative effect but Atypical do