AO1 - Drug Therapy

• Antipsychotic drugs are the most common treatment for schizophrenia, some may require a short course whereas others may require them for a life time or face reoccurrence of symptoms - there are two types:

  • Typical antipsychotics - first generation, used more often
  • Atypical antipsychotics - second generation, may be used if symptoms do not improve
• Typical antipsychotics - 1st generation, e.g. Chlorpromazine
• Typical antipsychotics such as Chlorpromazine are dopamine antagonists, they reduce levels of DA activity in the brain

  • Chlorpromazine also works by binding to the D2 receptors on post synaptic neurons to reduce the action of dopamine - this reduces dopamine activity levels and results in a reduction in positive symptoms, such as hallucinations
  • They are also used as a sedative and can be used to calm patients
• Atypical antipsychotics - 2nd generation, e.g. Clozapine
• Atypical antipsychotics such as Clozapine act upon both dopamine and serotonin

  • Clozapine also works by binding to the D2 receptors (dopamine antagonists) on post synaptic neurons to reduce the action of dopamine - this reduces dopamine activity levels and results in a reduction in positive symptoms, such as hallucinations
  • They also act as agonists upon serotonin receptor sites to increase serotonin activity levels - this reduces negative symptoms such as a lack of emotions as it helps to improve mood and reduce depression and anxiety in patients
• • Typical antipsychotics - Chlorpromazine - 1st generation - dopamine antagonist
  • Atypical antipsychotics - Clozapine - 2nd generation - dopamine antagonist AND serotonin agonist
• Atypical antipsychotics are associated with agranulocytosis, which is a blood condition where there are low levels of white blood cells, preventing an individual fighting off disease and illness

  • If prescribed clozapine, patients will be regularly monitored for signs of agranulocytosis by having blood tests
  • Only prescribed if typical antipsychotics are not effective or if the patient has severe negative side effects, e.g. suicidal ideation
• Typical antipsychotics can give patients parkinsonism, which affects their motor movements and can be quite distressing to a previously fit and able individual