Zusammenfassung der Ressource
Biological Therapies
- CONVENTIONAL ANTIPSYCHOTICS
- Phenothiazine linked to antihistamine
drugs for cold + asthma.
- Derivative, chlorpromazine =eff/
calming sym/s SZ.
- Block eff/s of dopamine = reduce
symp/s. - Dop/ ANTAGONISTS - bind
to dop/ receptors (D2 recep/s) - do
not stimulate thus block action.
- By reducing stimulation dop/ recep/s - reduce acute, pos/ symp/s (e.g...)
- Pos/ Symp/s: most common treatment. Eff/ for 70%. Julien (2005) -
reduce pos/ symp/s + decrease av/r length time hospitalised.
Relatively norm/ life in community. "Long Stay" to "Short Stay" condition.
- Wide Range Symp/s: eff/ for some not
others. Substantial proportion not helped.
- When to Measure: episodic -
periods symp/ free.
- Placebo Effects: Receiving attention,
therapist / benefitting specific
therapy. Overcome by using control
group (waiting list patients)
- APPROPRIATENESS: Side Effects: serious -
20-25% disordered motor movements
(tremors, involuntary tics (Tardive Dyskenesia))
- 50% stop 1st year. Harm - ppl prefer not to take.
- ATYPICAL ANTIPSYCHOTICS
- Range of drugs as eff/ as conventional but avoid problems.
- Clozapine - eff/ pos/
symp/s when indiv/s
resistant to
phenothiazines.
- Temporarily block D2 recep/s + rapidly
dissociate norm/ dop/ transmission.
- Characteristic responsible for lower
levels side eff/s (Tardive Dys/)
- Block SEROTONIN recep/s - precise
biochemical mechanisms unclear.
- Neg/ Symp/s: deLima et al
(2005) - atypical improve neg/
symp/s. = More eff/
- APPROPRIATENESS:
- Fewer Side Eff/s: main advantages, motor side eff/s sig/
reduced. Lower likelihood Tardive Dysk/. Convential - 30%
9 months showed TD / 5% atypical (Jeste et al, 1999)
- Relapse Rates Lower: more likely perservere. = more app/.
- Serious Side Effects: Fewer but serious. Immune system =
AGRANULOCYTOSIS - lowers white blood cells. Vulnerable
to infection = fatal. 1%-2% patients.
- Blood monitored regularly - expensive, time consuming.
Commitment + time for correct dosage.
- Ethical Issues: (Hallucinations, delusions - not able to give informed consent