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DRUG THERAPY - TYPICAL + ATYPICAL ANTIPSYCHOTICS - Coggle Diagram
DRUG THERAPY - TYPICAL + ATYPICAL ANTIPSYCHOTICS
Atypical antipsychotics
1970's - atypical antipsychotics = developed to be more effective + reduce side effects of typical antipsychotics
Improve + symptoms
Improve cognitive impairment
Only temporarily block D2 receptors
Then rapidly dissociate to allow normal dopamine transmission + include drugs such as clozapine
Far more affective than typical antipsychotics
Only used when other treatments fail
Side effects = blood disorders (agranulocytsis) which can potentially be fatal
Clozapine
binds to dopamine receptors but also serotonin + glutamate receptors which improves mood + reduces depression/anxiety + improves cognitive functioning
Often prescirbed when patient is at high risk of suicide (30-50% patients attempt suicide) + have the additional benefit of having less effect on dopamine systems that control movement
Risperidone
- another atypical antipsychotic - introduced in 1990s in attempt to produce a drug as effective as Clozapine but with less side effects - effects last 2 weeks + drug works by binding to dopamine + serotonin receptors - but it binds more strongly to dopamine than Clozapine - therefore is more effective in small doses = less side effects
Prime treatment for Sz = antipsychotic drugs
Antipsychotics = help patients function with life + are initially used and then combined with therapy
Typical + Atypical antipsychotics = both work by reducing the effects of dopamine on particular areas of the brain
Typical antipsychotics
Traditional/first generation drugs - first introduced in the 1950's
Example = Chlorpromazine
There is a strong association between
Chlorpromazine
+ the dopamine hypothesis
These drugs act as an antagonist in the dopamine system + reduces the action of dopamine
They work by blocking dopamine receptors in the synapse of the brain + reducing the action of dopamine
This normalises dopamine in key areas of the brain + therefore reduces hallucinations and helps improve positive symptoms of Sz
75& of D2 receptors must be blocked for the drugs to be effective + this can lead to undesirable effects
Chlorpromazine is also an effective sedative + is used to calm patients admitted to hosptial who are very anxious
DRUG THERAPY = CHEAPER + MORE ACCESSIBLE IN COMPARISON TO THERAPY
Antipsychotics - most serious side effects = NMS which occurs when drugs block dopamine in the hypothalamus + result in high temperature, delirium, coma/ultimatetly fatal
Atypical = fewer side effects - but patients still may develop agranulocytis (blood disorder) + need regular blood tests
The use of drugs with Sz patients does raise ethical isssues
Therapy can require high IQ in order to participate effectively in treatment
But, drugs do have many side effects e.g. weight gain, dizziness, involuntary facial movements
E.g. it is questionable whether or not severely affected patients can give informed consent to medication - A limitation is that drugs may simply be supressing symptoms as drugs to not tret the cause of the issue unlike therapy
MELTZER - EFFECTIVENESS OF DRUGS
This highlights the effectiveness of drugs as when one drug is unsuccessful in alleviating the symptomsof Sz, another drug may be more successful
Found that clozapine was effective in 30-50% of treatment resistant cases where typical antipsychotics have failed
CONTRADICTORY EVIDENCE - HEALY (2012)
Studies have also only focus on the short term effects which implies that long term effects are unknown + also suggests that antipsychotics have powerful calming effects
This means that it is easy to demonstrate positive effect on patients + it not the same as saying it reduces the severity of their psychosis. - highlights limitations of previous studied that suggest antipsychotics are effective in treating Sz
Suggests that successful trials have had their data published multiple times which exaggerates the effects of these drugs
DRUGS MAY SIMPLY BE A 'CHEMICAL COSH'
Antipsychotics have been used in hospital situations to calm patients and make it easier for staff to work with, rather than to benefit the patients themselves
Short-term use of antipsychotics to calm patients is recommended by the National Institute for Heath and Care Excellence (NICE)
However, this practice is seen by some and human right abuse + raises ethical issues in the use of antipsychotic drugs with Sz patients