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Drug Therapies - Coggle Diagram
Drug Therapies
Evaluation
Thornley et al (2003) found chlorpromazine was effective. Data from 13 trials showed it was associated with better functioning and reduced symptoms.
Potentially serious side effects e.g. Tardive Dyskinesia, Neuroleptic Malignant Syndrome which can be caused by a reduction of dopamine to the hypothalamus.
Much of the research into antipsychotics was conducted on animals so humans may react differently but it is unethical to perform drug tests on humans.
Drug therapy is quicker, easier and less threatening than talking therapies, drugs reduce symptoms directly from the cause whereas talking therapies take longer.
May be used as 'chemical cosh' to calm patients down in hospital. This makes them easier to cooperate with, however some patients may be overmedicated and not actually being treated.
Typical Antipsychotics
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Block dopamine receptors in the synapses. Initially dopamine levels increase when taking a typical antipsychotic but then production is reduced.
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CHLORPROMAZINE: has a sedation effect due to affecting histamine receptors so used to calm anxious patients in hospital.
Atypical Antipsychotics
CLOZAPINE: acts on dopamine, serotonin and glutamate to improve mood. Reduced depression and anxiety as well as improving cognitive functioning. Also improve mood which is important as up to 50% of schizophrenics attempt suicide. Can cause agranulocytosis (blood clots).
Targets dopamine and serotonin, reduced positive and negative symptoms.
RISPERIDONE: binds to dopamine and serotonin receptors but binds more strongly to dopamine receptors and so is effective in smaller doses as well as having fewer side effects.
Dosages
Chlorpromazine: 400-800mg per day, taken as syrup as absorbed faster than tablets.
Risperidone: 4-8mg per day, can be taken as a tablrt, syrup or injection.
Clozapine: 300-450mg, no injection due to fatal side effects, blood tests needed regularly to check blood isn't thinning too much.
Bagnall et al (2003)
PROCEDURE: 171 randomly controlled trials, 52 non-randomised trials. Data also taken from 31 economic evaluations of antipsychotic treatments - analysed by 2 independent researchers.
FINDINGS: atypical drugs were more effective overall but they are more expensive, no difference between the drug treating the onset of schizophrenia or when the patients had other issues e.g. depression, substance abuse problems.
CONCLUSION: Atypical antipsychotics more effective but no 1 drug is superior in all cases,
Sertindole was removed as a prescription drug as it was linked to heart failure.