12.2.4

Drug Therapies

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Drug Therapies - Typical

The most common treatment for schizophrenia involves the use of antipsychotic drugs. They are are usually categorised as either typical and atypical.

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Drug treatments

  • The antipsychotic drugs used to treat schizophrenia generally fall into one of two categories:
    • The older typical, or traditional drugs developed in the 1950s.
    • The more modern atypical, or second generation drugs.
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Typical antipsychotic drugs

  • Typical antipsychotics act as antagonists to the dopamine system (a collection of nerve cells in the brain), reducing the action of dopamine (a chemical messenger in the brain) by blocking dopamine receptors in the synapses.
  • This means they act in a way that supports the dopamine hypothesis. The dopamine hypothesis says that the dopamine system of schizophrenia patients is overreactive.
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Chlorpromazine

  • Chlorpromazine is one of the oldest drugs used in the treatment of schizophrenia.
  • It can be administered as tablet, a syrup or through an injection. A maximum dosage of 100mg per day is administered orally. The dosage is increased gradually.
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Effects of Chlorpromazine

  • Initially, after taking Chlorpromazine, dopamine levels typically rise before falling.
  • The dopamine-antagonist effect normalises neurotransmission in key brain areas, reducing symptoms such as hallucinations.
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Other uses of Chlorpromazine

  • Chlorpromazine is also useful as a sedative. The reasons for this are unclear, but it is thought to be related to its effect on histamine receptors.
  • Because of its sedative properties, Chlorpromazine is often used to calm patients, both in schizophrenia and other conditions. Chlorpromazine is most often used when patients arrive at hospital with increased feelings of anxiety.

Drug Therapies - Atypical

The most common treatment for schizophrenia involves the use of antipsychotic drugs. They are usually categorised as either typical and atypical.

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Atypical drugs

  • Atypical antipsychotic drugs were designed to improve the effectiveness of typical antipsychotics and reduce side-effects.
  • It is not always known how atypical antipsychotic drugs work.
  • Atypical antipsychotic drugs include Clozapine and Risperidone.
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Clozapine

  • Clozapine was first developed in the 1960’s.
  • Clozapine was first trialled in the 1970’s before being briefly withdrawn following the deaths of some patients from a blood condition called agranulocytosis.
  • After it was withdrawn, Clozapine was re-marketed because of its success in the treatment of resistant schizophrenia that hadn't responded to other treatments.
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Clozapine cont.

  • Because of its side-effects, Clozapine is not available as an injection.
  • Daily dosage ranges from 300mg to 450mg per day.
  • Clozapine binds to dopamine receptors. But, unlike Chlorpromazine, Clozapine also acts on serotonin and glutamate receptors, which is thought to improve mood and reduce depression and anxiety.
  • Because of its mood-enhancing properties, Clozapine is often used with patients at high risk of suicide (40% to 50% schizophrenic sufferers attempt suicide).
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Risperidone

  • Risperidone is an antipsychotic drug developed in the 1990’s.
  • Risperidone is as effective as Clozapine but without the serious side-effects.
  • It is administered in tablet, syrup and injection, with the injections lasting about two weeks.
  • Like other antipsychotic drugs, it is first administered in small doses and then increased up to a maximum of 12mg. This is a much lower dosage than other antipsychotics.
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Risperidone cont.

  • Risperidone is thought to bind to dopamine and serotonin receptors, but binds more strongly to dopamine receptors than Clozapine. This makes it more effective in smaller doses.
  • There is some evidence of side-effects, but these are few.

Jump to other topics

1Social Influence

2Memory

3Attachment

4Psychopathology

5Approaches in Psychology

6Biopsychology

7Research Methods

8Issues & Debates in Psychology (A2 only)

9Option 1: Relationships (A2 only)

10Option 1: Gender (A2 only)

11Option 1: Cognition & Development (A2 only)

12Option 2: Schizophrenia (A2 only)

13Option 2: Eating Behaviour (A2 only)

14Option 2: Stress (A2 only)

15Option 3: Aggression (A2 only)

16Option 3: Forensic Psychology (A2 only)

17Option 3: Addiction (A2 only)

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