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Biological therapies for schizophrenia - Coggle Diagram
Biological therapies for schizophrenia
Antipsychotics
Taken as: tablets, syrup, injection
required in short or long term
Helps patients function with life= initially used and then combined with therapy
Typical anti-psychotics
75% D2 receptors must be blocked for the drugs to be effective- this can lead to undesirable side effects
Chlorpromazine is also an effective sedative
Used to calm patients admitted to hospital who are very anxious
Atypical antipsychotics
1970s- developed to be more effective and reduce side effects
Improves
= Positive symptoms, negative symptoms as well as cognitive impairment
Only temporarily block D2, receptors and then rapidly dissociate to allow dopamine transmission
Clozapine
:
More effective than typical antipsychotic
Used when other treatments fail
Side effects= blood disorder ( agranulocytosis)-potentially fatal
General drugs paragraph
Cheaper
More accessible for wider population
Less disruptive
Side effects
= serious ( weight gain, dizziness, involuntary facial movements e.g. grimacing)
Most serious side effect side effect=NMS- dopamine in the hypothalamus-high temperature, delirium, coma, fatally
Anti-psychotics vs placebo
Thornley= reviewed studies: chlorpromazine v placebo=13 trials , 1121 patients= chlorpromazine: better overall functioning, reduced symptom severity, lower relapse rate
Support for antipsychotics
Meltzer
Clozapine: effective in 30-50% of treatment resistant cases where typical antipsychotics have failed
Antipsychotics depend on dopamine hypothesis
Current research shows dopamine levels may be too low in certain areas of brain
If this is the case- not clear how antipsychotics (dopamine antagonist )
Current understanding of the role of dopamine suggests that antipsychotics shouldn't work!
problems with evidence- HEALY
Successful trials have had their data published multiple times-exaggerates the effects
Studies only focus on the short term effects
Anti psychotics have powerful calming effects- easy to demonstrate positive effect on patients. This is not the same as saying it reduces the severity of their psychosis
Traditional /first generation drugs
Chlorpromazine
Dosage- gradually increased, max 100 mg