drug therapy

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Cards (8)

antipsychotics
used to treat schizophrenia
all work by reducing dopaminergic transmission - reducing action of dopamine in areas associated with symptoms (based on dopamine hypothesis)
types of antipsychotics
typical used to combat positive symptoms - products of overactive dopamine system (eg. chlorpromazine)
atypical combats positive and negative symptoms (eg. clozapine)
typical antipsychotics
dopamine antagonists (bind to and block dopamine receptors)
d levels build up, then production reduced
reduce stimulation of dopamine system in mesolimbic pathway = reduction in positive symptoms
many side effects
atypical antipsychotics
dopamine antagonists (bind to and block dopamine receptors)
temporarily occupy receptors, rapidly dissociation
fewer extrapyramidal side effects
claimed to have effect on negative symptoms too
evidence for antipsychotics over placebos
Leucht et al meta-analysis
some taken off antipsychotic medication, given placebo
within 12 months
placebo 64% relapsed, antipsychotics only 27% relapsed
so, value as prevents relapse, use should still be weighed against side effects
ethical issues due to side effects
extrapyramidal side effects
movement problems such as tardive dyskinesia (involuntary movements)
may be v distressing for patient - may stop taking
lawsuits seeking compensation for suffering caused by tardive dyskinesia more common
atypical may be better than typical
Crossley et al meta-analysis
no significant diffs in effect on symptoms (efficacy)
BUT atypical had less extrapyramidal side effects - eg. less severe tardive dyskinesia
patients more likely to continue with medication = more likely to see symptom reduction
motivational deficits
Ross and Reid
argue when people given antipsychotics, reinforces idea than something is wrong with them
prevents them from thinking about other possible contributing stressors
reduces motivation to find solutions to stressors