Ch 15 TX  SCHIZOPHRENIA

    III. Antipsychotic Drugs

Neuroleptics (Decrese Dopamine Levels )
Thorazine
Mellaril
Stelazine
Haldol
Mode of Operation

 Atypical Neuroleptics (Decrese Dopamine & Serotonin)
As effective & sometimes more effective than neuroleptics
Less likely to cause Tardive Dyskinesia (10 fold decrease)
Zyprexa
Seroquel
Risperdal
Clozapine (aganulocytosis: life-threatening drop in white blood cells)

 COMPLIANCE PROBLEMS
 
In community and outpatient settings, 70%-80% of patients are either partially or totally noncompliant

Solution? Depot Antipsychotic Medication

It is a special preparation of the medication, which is given by injection. The medication is slowly released into the body over a number of weeks


EFFECTIVENESS of ANTIPSYCHOTIC DRUGS

MUCH IMPROVED MINIMAL IMPROVEMENT
NO CHANGE  
WORSE
DRUG=75% 
DRUG=20%
DRUG=5%  
DRUG=0            
PLACEBO=25%        
PLACEBO=14% PLACEBO=13% PLACEBO=48% 
 
.
 

                              
  SIDE EFFECTS

 Parkinsonian & related symptoms (20-40%)

 Tardive Dyskinesia(20%) (late appearing movement disorder)

 Neuroleptic Malignant Syndrome (1-2%)

              muscle rigidity, fever, altered consciousness autonomic dystonia