drug therapies

• There are two types of antipsychotic medication: typical (traditional) and atypical (second generation)
• Antipsychotics - reduce intensity of symptoms, especially positive symptoms
• Typical - first gen, since the 1950s. Work as dopamine antagonists and include chlorpromazine. Chlorpromazine also works as a sedative which helps to calm patients.
• Atypical - clozapine binds to dopamine receptors but also works on serotonin and glutamate, too; side effects are fewer but may be fatal. Risperidone developed in the 1990s, works in the same way as clozapine, with fewer side effects.
• Dopamine antagonists block dopamine receptors in the brain reducing the action of dopamine
• Tardive dyskinesia - side effect of typical antipsychotics, uncontrollable movements of the mouth and face.
• Thornley et al compared the effects of chlorpromazine compared with a placebo and found that patients taking chlorpromazine showed better overall functioning and reduced symptom severity.
• Meltzer also found clozapine to be 30-50% more effective than typical antipsychotics.
• Typical antipsychotics have side effects which can range from being mild to extreme and in some cases fatal. The most serious side effect is neuroleptic malignant syndrome (NMS).
• Because of these side effects, patients may avoid their medication, increasing the risk of relapse and therefore decreasing the drug's effectiveness.
• Healy (2012) suggested some successful trials have had their data published multiple times, exaggerating the evidence for positive effects.
• Healy also suggested that because antipsychotics have calming effects, it is easy to demonstrate a positive effect on patients but it doesn’t mean they reduce the severity of psychosis.
• Most published studies assess short-term benefits over long-term benefits and compare patients who keep taking antipsychotics to those suffering withdrawal after having stopped taking them.